Palliative care physicians' experiences of end-of-life communication: A focus group study.

The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.

Four essential drugs needed for quality care of the dying: a Delphi-study based international expert consensus opinion.

Purpose: The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among physicians working in specialist palliative care.

Material And Methods: Within OPCARE9, a European Union seventh framework project aiming to optimize end-of-life cancer care, we conducted a Delphi survey among 135 palliative care clinicians in nine countries.

Complexity in non-pharmacological caregiving activities at the end of life: an international qualitative study.

Background: In late-stage palliative cancer care, relief of distress and optimized well-being become primary treatment goals. Great strides have been made in improving and researching pharmacological treatments for symptom relief; however, little systematic knowledge exists about the range of non-pharmacological caregiving activities (NPCAs) staff use in the last days of a patient's life.

Methods And Findings: Within a European Commission Seventh Framework Programme project to optimize research and clinical care in the last days of life for patients with cancer, OPCARE9, we used a free-listing technique to identify the variety of NPCAs performed in the last days of life.

Issues and needs in end-of-life decision making: an international modified Delphi study.

Background: end-of-life decision making is an important aspect of end-of-life care that can have a significant impact on the process of dying and patients' comfort in the last days of life.

Aim: the aim of our study was to identify issues and considerations in end-of-life decision making, and needs for more evidence among palliative care experts, across countries and professions.

Participants: 90 palliative care experts from nine countries participated in a modified Delphi study.

Information of imminent death or not: does it make a difference?

Purpose: This study examines whether end-of-life care for patients with cancer who were informed about imminent death differs from care for those patients with cancer who were not informed.

Patients And Methods: This study included all cancer deaths between 2006 and 2008 for which the patient did not lose his or her decision-making capacities until hours or days before death (N=13,818). These patients were taken from a national quality register for end-of-life care.

Artificial nutrition and hydration in the last week of life in cancer patients. A systematic literature review of practices and effects.

Background: The benefits and burdens of artificial nutrition (AN) and artificial hydration (AH) in end-of-life care are unclear. We carried out a literature review on the use of AN and AH in the last days of life of cancer patients.

Materials And Methods: We systematically searched for papers in PubMed, CINAHL, PsycInfo and EMBASE.

Deprotonation and regioselective addition of 2H-pyrazolo[3,4-c]quinolines to electrophiles.

The deprotonation and regioselective reaction of 2H-pyrazolo[3,4-c]quinolines with a variety of electrophiles is described. Electrophiles include benzaldehyde, DMF, carbon dioxide, and iodine. This method provides a direct route to a class of pharmacologically interesting compounds.

Piperazinyl CCR1 antagonists--optimization of human liver microsome stability.

The synthesis, biological activity, and pharmacokinetic profile of CCR1 antagonists are described.

Novel CCR1 antagonists with improved metabolic stability.

The synthesis, biological activity, and pharmacokinetic profile of novel CCR1 antagonists are described.

Photochemotherapy of oral lichen planus. A controlled study.

Photochemotherapy with 8-methoxypsoralen and long-wave ultraviolet light (PUVA) has become a useful alternative in dermatologic therapy. PUVA therapy has been successfully used in the treatment of severe psoriasis and cutaneous lichen planus. The aim of this investigation was to use PUVA in the treatment of oral lichen planus (OLP).

A longitudinal investigation of the individual consistency of plaque levels in adults.

The present investigation was designed to determine the individual variation of plaque levels in adults over a period of 3 months. The participants were 20 healthy subjects, 11 men and 9 women, with a mean age of 42.3 +/- 7.

Antiserum directed against chromogranin A and B (CAB) is a useful marker for peptide hormone-producing endocrine cells and tumors.

Certain proteins, such as the chromogranins, have a ubiquitous occurrence in nearly ail peptide hormone-producing cells. To date, little is known about their functional role as structural proteins, precursors of bioactive peptides, or enzymes. Such proteins may serve as markers for endocrine cells and tumors.

Pseudomonas 3 beta-hydroxysteroid dehydrogenase. Primary structure and relationships to other steroid dehydrogenases.

The 3 beta-hydroxysteroid dehydrogenase of Pseudomonas testosteroni commercially available was purified by an FPLC step and submitted to sequence determination by peptide analysis. The structure obtained reveals a 253-residue polypeptide chain, with an N-terminal, free alpha-amino group, and a low cysteine content. Comparisons with other hydroxysteroid dehydrogenases recently characterized reveal distant similarities with prokaryotic and, to some extent, also eukaryotic forms of separate specificities.

Characterization of the murine corticosteroid binding globulin: variations between mammalian forms.

Corticosteroid binding globulin (CGB) from term-pregnant mouse serum was isolated and characterized by peptide analysis after treatment with CNBr and Lys-specific protease, respectively. Amino acid sequence analysis of six segments, covering 189 of 383 positions in different regions of the protein, showed unexpectedly low overall homology (60%) to the indirectly deduced human amino acid sequence previously reported. However, some segments displayed a greater resemblance to their human counterparts.

Activation of rat liver microsomal glutathione transferase by limited proteolysis.

The activity of rat liver microsomal glutathione transferase is increased by limited tryptic proteolysis; the membrane-bound and purified forms of the enzyme are activated about 5- and 10-fold respectively. The cleavage sites that correlate with this activation were determined by amino acid sequence analysis to be located after Lys-4 and Lys-41. Differences in the relative extent of cleavage at these two sites did not consistently affect the degree of activation.

Re- and allotransplantation of teeth--an experimental study in monkeys.

In each of six monkeys one of the permanent lateral incisors with uncompleted root development was replanted. At the same time the contralateral incisors in four of the monkeys were allotransplanted by pairs. The remaining two contralateral incisors served as controls.

A standardized meal stimulation test of the endocrine pancreas for early detection of pancreatic endocrine tumors in multiple endocrine neoplasia type 1 syndrome: five years experience.

Forty-nine members of 6 families with multiple endocrine neoplasia type 1 (MEN 1) were investigated with a standardized meal stimulation test to detect the presence of pancreatic endocrine tumors. Fifteen age-matched subjects and 4 patients with primary hyperparathyroidism also were studied. Serum pancreatic polypeptide (PP), gastrin, and insulin as well as plasma glucagon and somatostatin concentrations were determined before and during the test meal.

The effect of 20 Mg omeprazole daily on serum gastrin, 24-h intragastric acidity, and bile acid concentration in duodenal ulcer patients.

Serum gastrin, 24-h intragastric acidity, and bile acid concentrations were measured during physiologic conditions in 10 patients with duodenal ulcer disease. Omeprazole, 20 mg daily, for 8 days reduced acidity by greater than or equal to 99% in six patients and by 47-54% in four patients. The degree of acid reduction was related to the area under the plasma omeprazole concentration time curve (AUC).

Measles virus hemagglutinin. Removal of the initiator methionine in the mature protein, and evidence for further processing to produce a 'ragged' end.

Measles virus hemagglutinin has been isolated by immunoadsorption. The total composition of the protein and its N-terminal amino acid sequence give data matching the structure indirectly deduced from cDNA. However, direct analysis of the hemagglutinin also shows that the mature protein is proteolytically processed and has a partly heterogeneous N-terminus.

Isolation and characterization of variant IGF-1 as well as IGF-2 from adult human brain.

The forms of somatomedin present in the adult human brain have been characterized in this study. Two peptides were purified by acidification, size exclusion chromatography, affinity chromatography, FPLC and HPLC. Structural analysis identified these peptides as the variant form of IGF-1 with a truncated N-terminal region earlier isolated from human fetal brain and IGF-2.

Replantation of avulsed teeth after long extra-alveolar periods.

In 11 patients, 18 teeth, with extra-alveolar periods ranging from 6 h to 48 days were replanted after root-filling with chloroform resin and guttapercha. After observation periods from 1 to 7 years, only 1 tooth was lost (after 5 years), but the remaining 17 teeth were clinically well functioning. All teeth were ankylotic and subjected to replacement resorption of various extent.

Elevated serum levels of pancreatic polypeptide are related to impaired glucose handling in inflammatory states.

Glucose handling and insulin secretion were studied in patients with inflammatory connective tissue diseases and correlated to circulating levels of immunoreactive pancreatic polypeptide (PP). The patients had normal fasting serum levels of insulin and normal insulin response to intravenous glucose loading. Ten of 16 patients had an impaired glucose tolerance, defined as a K rate of less than one.

Transluminal angioplasty for renovascular hypertension complicated by pregnancy.

Percutaneous transluminal angioplasty was successfully used in the treatment of renovascular hypertension that resulted from fibromuscular hyperplasia in a 26-year-old woman who was four weeks' pregnant. The patient's BP normalized immediately. She had a normal pregnancy that terminated in the delivery of a full-term normal child.