Base de dados : MEDLINE
Pesquisa : E02.760.666 [Categoria DeCS]
Referências encontradas : 46464 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 4647 ir para página                         

  1 / 46464 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29447291
[Au] Autor:Tanuseputro P; Beach S; Chalifoux M; Wodchis WP; Hsu AT; Seow H; Manuel DG
[Ad] Endereço:Bruyère Research Institute, Ottawa, Ontario, Canada.
[Ti] Título:Associations between physician home visits for the dying and place of death: A population-based retrospective cohort study.
[So] Source:PLoS One;13(2):e0191322, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While most individuals wish to die at home, the reality is that most will die in hospital. AIM: To determine whether receiving a physician home visit near the end-of-life is associated with lower odds of death in a hospital. DESIGN: Observational retrospective cohort study, examining location of death and health care in the last year of life. SETTING/PARTICIPANTS: Population-level study of Ontarians, a Canadian province with over 13 million residents. All decedents from April 1, 2010 to March 31, 2013 (n = 264,754). RESULTS: More than half of 264,754 decedents died in hospital: 45.7% died in an acute care hospital and 7.7% in complex continuing care. After adjustment for multiple factors-including patient illness, home care services, and days of being at home-receiving at least one physician home visit from a non-palliative care physician was associated with a 47% decreased odds (odds-ratio, 0.53; 95%CI: 0.51-0.55) of dying in a hospital. When a palliative care physician specialist was involved, the overall odds declined by 59% (odds ratio, 0.41; 95%CI: 0.39-0.43). The same model, adjusting for physician home visits, showed that receiving palliative home care was associated with a similar reduction (odds ratio, 0.49; 95%CI: 0.47-0.51). CONCLUSION: Location of death is strongly associated with end-of-life health care in the home. Less than one-third of the population, however, received end-of-life home care or a physician visit in their last year of life, revealing large room for improvement.
[Mh] Termos MeSH primário: Hospitais/utilização
Visita Domiciliar/utilização
Assistência Terminal/métodos
[Mh] Termos MeSH secundário: Canadá
Estudos de Coortes
Morte
Feminino
Serviços de Assistência Domiciliar/tendências
Serviços de Assistência Domiciliar/utilização
Cuidados Paliativos na Terminalidade da Vida/tendências
Hospitalização/tendências
Hospitais/tendências
Seres Humanos
Masculino
Razão de Chances
Cuidados Paliativos
Médicos
Qualidade de Vida
Estudos Retrospectivos
Assistência Terminal/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191322


  2 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28462755
[Au] Autor:Hinkle KA; Wilkes J; McFadden M; Williams RV; Minich LL; Menon SC
[Ad] Endereço:1Division of Pediatric Cardiology,Department of Pediatrics,University of Utah,Salt Lake City,Utah,United States of America.
[Ti] Título:A multi-institutional study of factors affecting resource utilisation following the Fontan operation.
[So] Source:Cardiol Young;27(4):739-746, 2017 May.
[Is] ISSN:1467-1107
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The few studies evaluating data on resource utilisation following the Fontan operation specifically are outdated. We sought to evaluate resource utilisation and factors associated with increased resource use after the Fontan operation in a contemporary, large, multi-institutional cohort. This retrospective cohort study of children who had the Fontan between January, 2004 and June, 2013 used the Pediatric Health Information Systems Database. Generalised linear regression analyses evaluated factors associated with resource use. Of 2187 Fontan patients included in the study, 62% were males. The median age at Fontan was 3.2 years (inter-quartile range (IQR): 2.6-3.8). The median length of stay following the Fontan was 9 days (IQR: 7-14). The median costs and charges in 2012 dollars for the Fontan operation were $93,900 (IQR: $67,800-$136,100) and $156,000 (IQR: $112,080-$225,607), respectively. Postoperative Fontan mortality (30 days) was 1% (n=21). Factors associated with increased resource utilisation included baseline and demographic factors such as region, race, and renal anomaly, factors at the bidirectional Glenn such as seizures, valvuloplasty, and surgical volume, number of admissions between the bidirectional Glenn and the Fontan, and factors at the Fontan such as surgical volume and age at Fontan. The most strongly associated factors for both increased Fontan length of stay and increased Fontan charges were number of bidirectional Glenn to Fontan admissions (p<0.001) and Fontan surgical volume per year (p<0.001). As patient characteristics and healthcare-related delivery variables accounted for most of the factors predicting increased resource utilisation, changes should target healthcare delivery factors to reduce costs in this resource-intensive population.
[Mh] Termos MeSH primário: Técnica de Fontan/economia
Técnica de Fontan/mortalidade
Custos Hospitalares
Síndrome do Coração Esquerdo Hipoplásico/cirurgia
Tempo de Internação
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Recursos em Saúde/utilização
Ventrículos do Coração/anormalidades
Ventrículos do Coração/cirurgia
Seres Humanos
Lactente
Modelos Lineares
Masculino
Cuidados Paliativos
Complicações Pós-Operatórias
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1017/S1047951116001244


  3 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28466684
[Au] Autor:Spalding R; Kozlov E; Carpenter BD
[Ad] Endereço:1 Washington University in St. Louis, MO, USA.
[Ti] Título:Words Matter.
[So] Source:Int J Aging Hum Dev;85(1):123-130, 2017 06.
[Is] ISSN:1541-3535
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Palliative care consultation teams (PCCTs) provide input to other health-care providers working with patients who have life-limiting disease. This study examines whether the diction and phrasing of consultation recommendations in the electronic health record influence their implementation. We reviewed 288 verbatim PCCT recommendations that were made for 111 unique patients in a Veterans Affairs hospital and available in the electronic health record. Recommendations were coded for linguistic features, such as the presence of conditionals (e.g., "could") and tentative phrasing (e.g., "would suggest"). Each patient's subsequent treatment was followed in the medical record to determine whether PCCT recommendations were implemented. Only 57% of the consultation recommendations were eventually implemented. Recommendations that included a conditional word or phrase were significantly less likely to be implemented. In particular, recommendations that included the words "could" and "consider" were less likely to be implemented. PCCTs may enhance their effectiveness by attending to the subtle pragmatics of how they communicate with other health-care providers, particularly in electronic communication where nonverbal features of communication are unavailable.
[Mh] Termos MeSH primário: Comunicação
Registros Eletrônicos de Saúde/estatística & dados numéricos
Cuidados Paliativos/estatística & dados numéricos
Relações Profissional-Paciente
Encaminhamento e Consulta/estatística & dados numéricos
Comportamento Verbal
[Mh] Termos MeSH secundário: Seres Humanos
Assistência de Longa Duração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1177/0091415016685328


  4 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29292905
[Au] Autor:Henriksson R; Falkenius J; Norin S; Öhman D; Abrahamsson M; Lindquist M; Lööv SÅ
[Ad] Endereço:Onkologi & Patologi - Regionalt Cancercentrum STOCKHOLM, Sweden Onkologi & Patologi - Regionalt Cancercentrum STOCKHOLM, Sweden.
[Ti] Título:Register för nya läkemedel i cancervården ger värdefull hjälp - Visar en bra bild av hur läkemedlen används ­ patienten kan följas i den kliniska vardagen..
[So] Source:Lakartidningen;114, 2017 Nov 06.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Ab] Resumo:Register for new drugs in cancer care provides a picture of how the drugs are used in the daily clinical practice Today, an increasing number of cancer drugs are approved before traditional well-controlled phase 3 studies have been conducted and in many registration studies there is no participation of Swedish departments. This article describes the general experience of a caregiver initiated systematic follow-up of new cancer drugs that shows the possibility of obtaining a picture of the drug's use in routine care. From the register "New Pharmaceuticals in Cancer care", registrations from Stockholm-Gotland region are reported. The structure of the registry can be used with advantage in other therapeutic areas than cancer and can be supplemented with data from national and regional registers as well as quality registers including patient experiences. The knowledge is important to many actors in health care and can contribute to an evidence based, patient-safe and equal healthcare in accordance with current guidelines.
[Mh] Termos MeSH primário: Antineoplásicos
Neoplasias/tratamento farmacológico
Sistema de Registros
[Mh] Termos MeSH secundário: Androstenos/uso terapêutico
Antineoplásicos/administração & dosagem
Antineoplásicos/uso terapêutico
Bevacizumab/uso terapêutico
Neoplasias da Mama/tratamento farmacológico
Neoplasias da Mama/mortalidade
Neoplasias Colorretais/tratamento farmacológico
Neoplasias Colorretais/mortalidade
Uso de Medicamentos
Seres Humanos
Ipilimumab/uso terapêutico
Masculino
Melanoma/tratamento farmacológico
Melanoma/mortalidade
Neoplasias/mortalidade
Cuidados Paliativos/métodos
Feniltioidantoína/análogos & derivados
Feniltioidantoína/uso terapêutico
Projetos Piloto
Neoplasias da Próstata/tratamento farmacológico
Neoplasias da Próstata/mortalidade
Rádio (Elemento)/uso terapêutico
Taxa de Sobrevida
Suécia/epidemiologia
Suspensão de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androstenes); 0 (Antineoplastic Agents); 0 (Ipilimumab); 0 (MDV 3100); 0 (Radium-223); 2010-15-3 (Phenylthiohydantoin); 2S9ZZM9Q9V (Bevacizumab); G819A456D0 (abiraterone); W90AYD6R3Q (Radium)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


  5 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29236370
[Au] Autor:Ouellet N; Sylvain H; Thériault H
[Ad] Endereço:Département des sciences infirmières, Université du Québec à Rimouski Québec, Canada.
[Ti] Título:Fin de vie. Des soins de confort chez soi..
[So] Source:Perspect Infirm;14(2):48-51, 2017 Mar-Apr.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Serviços de Assistência Domiciliar
Cuidados Paliativos
[Mh] Termos MeSH secundário: Seres Humanos
Guias de Prática Clínica como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


  6 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29319371
[Au] Autor:Nieder C; Tollåli T; Haukland E; Reigstad A; Randi Flatøy L; Dalhaug A
[Ad] Endereço:a Departments of Oncology and Palliative Medicine , Nordland Hospital Trust , Bodø , Norway.
[Ti] Título:A Four-Tiered Prognostic Score for Patients Receiving Palliative Thoracic Radiotherapy for Lung Cancer.
[So] Source:Cancer Invest;36(1):59-65, 2018 Jan 02.
[Is] ISSN:1532-4192
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Palliative radiotherapy improves lung cancer related symptoms. Prognosis should be taken into account when deciding about fractionation. In this study, prognostic factors derived from multivariate analysis were used to assign a point sum reflecting 6-month survival. Four prognostic groups were compared. Performance status, lactate dehydrogenase, C-reactive protein, liver/adrenal gland metastases, and extrathoracic disease status significantly predicted survival and formed the basis of the score. The four groups had a median survival of 0.8, 1.6, 3.3, and 10.5 months (6-month survival 0, 10, 30, 70%; 12-month survival 0, 0, 12, 40%; p = 0.0001), respectively. In the unfavorable group best supportive care might be preferable.
[Mh] Termos MeSH primário: Neoplasias Pulmonares/patologia
Neoplasias Pulmonares/radioterapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Proteína C-Reativa/metabolismo
Fracionamento de Dose
Feminino
Seres Humanos
L-Lactato Desidrogenase/metabolismo
Neoplasias Pulmonares/metabolismo
Masculino
Meia-Idade
Análise Multivariada
Metástase Neoplásica/patologia
Metástase Neoplásica/radioterapia
Cuidados Paliativos/métodos
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein); EC 1.1.1.27 (L-Lactate Dehydrogenase)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1080/07357907.2017.1416394


  7 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29284068
[Au] Autor:Zerhouni S; Van Coevorden F; Swallow CJ
[Ad] Endereço:Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:The role and outcomes of palliative surgery for retroperitoneal sarcoma.
[So] Source:J Surg Oncol;117(1):105-110, 2018 Jan.
[Is] ISSN:1096-9098
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Categories of noncurative surgery for retroperitoneal sarcoma include: i) grossly incomplete resection (R2) of primary or locally recurrent tumor; ii) resection in the setting of distant metastatic disease; and iii) true palliative-intent symptom-directed surgery. The value of R2 resection is debatable, since most series do not report initial operative intent. Debulking surgery provides symptom relief in the majority of patients, but relief is generally not durable. Quality of life is poorly studied.
[Mh] Termos MeSH primário: Cuidados Paliativos
Qualidade de Vida
Neoplasias Retroperitoneais/cirurgia
Sarcoma/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Neoplasias Retroperitoneais/patologia
Sarcoma/patologia
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE
[do] DOI:10.1002/jso.24934


  8 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28463635
[Au] Autor:O'Hare AM; Song MK; Kurella Tamura M; Moss AH
[Ad] Endereço:1 Department of Medicine, University of Washington and Veterans Affairs Puget Sound Healthcare System , Seattle, Washington.
[Ti] Título:Research Priorities for Palliative Care for Older Adults with Advanced Chronic Kidney Disease.
[So] Source:J Palliat Med;20(5):453-460, 2017 May.
[Is] ISSN:1557-7740
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Older adults with advanced chronic kidney disease (CKD) often have multiple comorbid conditions, a high symptom burden, and limited life expectancy. There is mounting concern that the intensive patterns of care that many of these patients receive at the end of life are discordant with their values and preferences. The nephrology community has recognized that there are significant unmet palliative care needs in this population. In this article, we identify three broad areas of knowledge deficit where more evidence is needed to support the "best care possible" for this population: (1) what matters most to older adults with advanced CKD and their caregivers near the end of life; (2) how the nephrology community can best support older adults with advanced CKD to navigate complex treatment decisions throughout their illness; and (3) how the healthcare system should be reconfigured to promote patient- and family-centered care for older adults with advanced CKD. Research priorities include identifying opportunities for improving the end-of-life experience of older adults with CKD and their caregivers; developing and testing communication interventions before and during dialysis to ensure that treatment decisions reflect patients' preferences; and assessing the effectiveness of palliative care in improving quality of life for patients and caregivers, satisfaction with care, and aligning treatment decisions with patient goals and preferences.
[Mh] Termos MeSH primário: Diálise/métodos
Enfermagem Geriátrica/métodos
Cuidados Paliativos/métodos
Preferência do Paciente
Assistência Centrada no Paciente/métodos
Insuficiência Renal Crônica/enfermagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Tomada de Decisões
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1089/jpm.2016.0571


  9 / 46464 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29480823
[Au] Autor:Qiu HB; Zhou ZG; Feng XY; Liu XC; Guo J; Ma MZ; Chen YB; Sun XW; Zhou ZW
[Ad] Endereço:Department of Gastric and Pancreatic Surgery.
[Ti] Título:Advanced gastrointestinal stromal tumor patients benefit from palliative surgery after tyrosine kinase inhibitors therapy.
[So] Source:Medicine (Baltimore);97(2):e9097, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The role of palliative surgery is controversial in advanced gastrointestinal stromal tumors (GIST) after tyrosine kinase inhibitors (TKIs) therapy.We evaluated safety and clinical outcomes in a single institution series of advanced GIST patients from January 2002 to December 2008.One hundred and fifty-six patients had been recruited, including 87 patients underwent surgical resection and 69 patients kept on TKIs treatment. Four patients had major surgical complications. Median follow-up was 38.3 months, the overall survival (OS) and progression-free survival (PFS) of the patients in surgical group were longer than the nonsurgical group, PFS: 46.1 versus 33.8 months (P < .01), OS: 54.8 versus 40.4 months. In the subgroup analysis for the patients received surgery, the median PFS for patients with progression disease, stable disease, and partial response was 33.3, 51.5, and 83.0 months, respectively (P < .01). Median OS was 68.0 months in those with only liver or peritoneal metastases, and 45.3 months in those with both metastases. Median PFS of patients underwent R0/R1 resection was 73.6 months compared with 35.8 months in R2 resection patients (P < .01).Patients with advanced GISTs have prolonged OS after debulking procedures. Surgery for patients who have responsive disease after TKIs treatment should be considered.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Tumores do Estroma Gastrointestinal/tratamento farmacológico
Tumores do Estroma Gastrointestinal/cirurgia
Cuidados Paliativos
Inibidores de Proteínas Quinases/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Intervalo Livre de Doença
Feminino
Seguimentos
Tumores do Estroma Gastrointestinal/mortalidade
Tumores do Estroma Gastrointestinal/patologia
Seres Humanos
Mesilato de Imatinib/uso terapêutico
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/secundário
Masculino
Meia-Idade
Neoplasias Peritoneais/mortalidade
Neoplasias Peritoneais/secundário
Proteínas Tirosina Quinases/antagonistas & inibidores
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Protein Kinase Inhibitors); 8A1O1M485B (Imatinib Mesylate); EC 2.7.10.1 (Protein-Tyrosine Kinases)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009097


  10 / 46464 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29466595
[Au] Autor:Rosenberg LB
[Ad] Endereço:Division of Geriatrics and Palliative Care, Massachusetts General Hospital, Boston, Massachusetts.
[Ti] Título:A Teaching Case.
[So] Source:JAMA;319(7):657-658, 2018 Feb 20.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicina Paliativa/educação
Relações Médico-Paciente
Doente Terminal
[Mh] Termos MeSH secundário: Seres Humanos
Medicina Interna/educação
Internato e Residência
Masculino
Cuidados Paliativos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0071



página 1 de 4647 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde