Hospital and Health System Policies Concerning the California End of Life Option Act.

The End of Life Option Act (EOLOA) legalized physician aid in dying for competent, terminally ill Californians in 2016. The law allows clinicians, hospitals, and health systems to decide whether to participate. About 4 in 10 California hospitals permit the EOLOA, but little is known about their approaches and concerns.

Hospital Responses to the End of Life Option Act: Implementation of Aid in Dying in California.

This survey study of statewide California hospitals evaluates the prevalence and institutional characteristics of hospitals and health systems that have either implemented or opted out of the state’s End of Life Option Act.

Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel.

Context: Despite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives.

Objective: The aim of this study was to develop a consensus definition of ACP for adults.

Methods: We convened a Delphi panel of multidisciplinary, international ACP experts consisting of 52 clinicians, researchers, and policy leaders from four countries and a patient/surrogate advisory committee.

Use of the Physician Orders for Life-Sustaining Treatment among California Nursing Home Residents.

Background: Physician Orders for Life-Sustaining Treatment (POLST) is a tool that facilitates the elicitation and continuity of life-sustaining care preferences. POLST was implemented in California in 2009, but how well it disseminated across a large, racially diverse population is not known and has implications for end-of-life care.

Objective: To evaluate the use of POLST among California nursing home residents, including variation by resident characteristics and by nursing home facility.

Recessive CLCN1 mutation presenting as Thomsen disease.

This case report describes a young man referred for electrodiagnostic evaluation for hand stiffness and intermittent numbness. His needle electromyography revealed diffusely increased insertional and spontaneous motor activity in the form of myotonic discharges. Given the finding of symptomatic myotonia also in his mother, Thomsen myotonia was suspected.

Increased frequency of HLA-B44 in recurrent sinopulmonary infections (RESPI).

To test whether MHC alleles associated with common variable immune deficiency (CVID) might also be over-represented in patients with normal serum immunoglobulin levels who suffer with recurrent sinopulmonary infections (RESPI), we identified 62 consecutive RESPI patients and compared their HLA-B and HLA-DR antigen frequencies to those of 60 consecutive patients with CVID, 1627 Alabama Caucasian bone marrow donors, and 997,230 published US Caucasians. Either HLA-B44, -B8, -DR3(17), or -DR7 was present in 74% of the RESPI and 85% of the CVID patients. HLA-B44 prevalence in particular proved identical between RESPI and CVID.

Distribution and mitogen response of peripheral blood lymphocytes after exertional heat injury.

To determine whether immune disturbances during exertional heat injury (EHI) could be distinguished from those due to exercise (E), peripheral lymphocyte subset distributions and phytohemagglutinin-stimulated CD69 mitogen responses as discriminated by flow cytometry were studied in military recruits [18.7 +/- 0.3 (SE) yr old] training in warm weather.

Immune cell function testing: an adjunct to therapeutic drug monitoring in transplant patient management.

Each year, 55 000 organ transplants are performed worldwide. Cumulatively, the number of living organ recipients is now estimated to be over 300 000. Most of these transplant recipients will remain on immunosuppressive drugs for the remainder of their lives to prevent rejection episodes.

Allele-specific in situ analysis of microchimerism by fluorescence resonance energy transfer (FRET) in nonhuman primate tissues.

Rhesus monkeys are relevant models for tolerance induction. Hematopoetic chimerism is believed to be one of these strategies. The purpose of this study was to detect donor class I A locus allele specific mRNA in Rhesus monkey kidney recipient.