Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?

Purpose: Infective endocarditis (IE) is a heterogeneous disease undergoing epidemiological changes. Whether those changes have an impact on the correlates of embolic events (EE) remains unclear. We analyzed the correlates of EE and proposed a diagnostic score model in a large contemporary cohort.

Complimentary Role of Comprehensive Palliative Care Treatment to Intrathecal Therapy: Case Report.

Intrathecal therapy with implanted devices is often reported in some recommendations.for the management of difficult cancer pain However, data is often biased by optimistic view and poor assessment. We report a case of patient in which a comprehensive and complex palliative care treatment was effective in managing a patient who was implanted a subcutaneous port for intrathecal analgesia This patient had many characteristics of a difficult pain, really defined as refractory due to various negative prognostic pain factors, such as neuropathic pain and psychological distress.

A month of diagnostic imaging studies in an acute supportive/palliative care unit.

Aim: The aim was to assess the characteristics of patients who required imaging studies during admission to an acute supportive palliative care unit (ASPCU).

Methods: A consecutive number of patients who performed imaging studies during ASPCU admission in a month period were assessed. Epidemiological data, ongoing anticancer treatment, cancer diagnosis, reasons for admission, referral, and type of imaging study were recorded.

Malnutrition is Associated With Fatigue and Anxiety in Advanced Cancer Patients Admitted to Home Palliative Care.

Objective: Information regarding the nutrition profile of advanced cancer patients followed at home is lacking. The aim of this study was to assess the nutritional status of patients who were admitted to specialized home palliative care, and examine eventual factors associated with malnutrition.

Design: Cross-sectional.

Top Ten Tips Palliative Care Clinicians Should Know About Designing a Clinical Trial in Palliative Care.

The palliative care field is experiencing substantive growth in clinical trial-based research. Randomized controlled trials provide the necessary rigor and conditions for assessing a treatment's efficacy in a controlled population. It is therefore important that a trial is meticulously designed from the outset to ensure the integrity of the ultimate results.

Influence of aging on opioid dosing for perioperative pain management: a focus on pharmacokinetics.

The older population continues to grow in all countries, and surgeons are encountering older patients more frequently. The management of postoperative pain in older patients can be a difficult task. Opioids are the mainstay of perioperative pain control.

End-of-life Care in the Intensive Care Unit and Ethics of Withholding/Withdrawal of Life-sustaining Treatments.

The medical progress has produced improvements in critically ill patients' survival to early phases of life-threatening diseases, thus producing long intensive care stays and persisting disability, with uncertain long-term survival rates and quality of life. Thus, compassionate end-of-life care and the provision of palliative care, even overlapping with the most aggressive of curative intensive care unit (ICU) care has become crucial. Moreover, withdrawal or withholding of life-sustaining treatment may be adopted, allowing unavoidable deaths to occur, without prolonging agony or ICU stay.

Top Ten Tips Palliative Care Clinicians Should Know About Interpreting a Clinical Trial.

Evidence-based practice is foundational to high-quality palliative care delivery. However, the clinical trials that compose the evidence base are often methodologically imperfect. Applying their conclusions without critical application to the clinical practice context can harm patients.

Opioid analgesic dose and route conversion ratio studies: a scoping review to inform an eDelphi guideline.

Background: Clinicians regularly prescribe opioids to manage acute and chronic cancer pain, frequently to address acute postoperative pain, and occasionally to manage chronic non-cancer pain. Clinical efficacy may be suboptimal in some patients due to side effects and/or poor response, and opioid rotation/switching (conversions) is frequently necessary. Despite the widespread practice, opioid conversion ratios are inconsistent between clinicians, practices, and countries.

Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study.

Background: Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively.

Aims: We conducted a retrospective real-world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients.

Material And Methods: Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed.

Characteristics of Patients With Amyotrophic Lateral Sclerosis Followed by a Home Palliative Care Team.

Background: Information about patients with amyothrophic lateral sclerosis (ALS) followed at home is limited.

Objectives: To assess patients's characteristics at admission to a home palliative care program based on a multidisciplinary team, and the temporal course along the trajectory of ALS disease.

Design: Retrospective.

Report on palliative sedation medication usage: a survey of palliative care experts in Eight European countries.

Background: The practice of palliative sedation continues to raise ethical questions among people, which in turn leads to its varied acceptance and practice across regions. As part of the Palliative Sedation European Union (EU) project, the aim of the present study was to determine the perceptions of palliative care experts regarding the practice of palliative sedation in eight European countries (The Netherlands, Belgium, Germany, UK, Italy, Spain, Hungary, and Romania).

Methods: A specifically designed survey, including questions on the most frequently used medications for palliative sedation, their availability per countries and settings, and the barriers and facilitators to the appropriate practice of palliative sedation was sent to expert clinicians involved and knowledgeable in palliative care in the indicated countries.

Chrono-Endocrinology in Clinical Practice: A Journey from Pathophysiological to Therapeutic Aspects.

This review was aimed at collecting the knowledge on the pathophysiological and clinical aspects of endocrine rhythms and their implications in clinical practice, derived from the published literature and from some personal experiences on this topic. We chose to review, according to the PRISMA guidelines, the results of original and observational studies, reviews, meta-analyses and case reports published up to March 2024. Thus, after summarizing the general aspects of biological rhythms, we will describe the characteristics of several endocrine rhythms and the consequences of their disruption, paying particular attention to the implications in clinical practice.

The Thousand Faces of Invasive Group A Streptococcal Infections: Update on Epidemiology, Symptoms, and Therapy.

Invasive infections caused by (iGAS), commonly known as Group A Streptococcus, represent a significant public health concern due to their potential for rapid progression and life-threatening complications. Epidemiologically, invasive GAS infections exhibit a diverse global distribution, affecting individuals of all ages with varying predisposing factors. The pathogenesis of invasive GAS involves an array of virulence factors that contribute to tissue invasion, immune evasion, and systemic dissemination.

Radiofrequency ablation for cancer pain with inadequate opioid response.

Data on the use of radiofrequency (RT) to ablate a tumor mass-causing pain have not been reported. A male in his 50s, diagnosed with a pelvic relapse of rectal cancer, was admitted for pain from the left groin to the perineum. The principal findings of contrast-enhanced computed tomography (CT) revealed the presence in the pelvic area of large solid tissue infiltrating the internal obturator muscle and eroding the vertebral column of the acetabulum.

Inpatient deaths by medical service: characteristics in a comprehensive cancer centre.

Aim: To examine the intensity of care in the last 3 days of life in different medical settings of a comprehensive cancer centre.

Methods: In this retrospective study, the charts of patients who died in hospital from July 2019 to June 2023 were reviewed. The units taken into consideration were acute palliative care unit (APCU), oncology (ONC) and haematology (HEM), which included also the transplantation unit.

Fast-track anesthesia and outcomes in hepatopancreatic cancer surgery: a retrospective analysis.

Aim: To assess the feasibility of a fast-track anesthesia protocol for hepatopancreatobiliary cancer surgery.

Methods: Retrospective analysis of consecutive sample of patients who underwent hepatopancreatic surgery for cancer for a period of 12 months in a high volume cancer center. Blended anesthesia was performed for most patients who were then observed in a recovery room area until achieving a safety score.

Pain Catastrophizing in Cancer Patients.

Background: Pain catastrophizing is a group of negative irrational cognitions in the context of anticipated or actual pain. The aim of this study was to decipher the possible role of catastrophism on pain expression and outcomes after a comprehensive palliative care treatment.

Methods: A consecutive sample of patients with uncontrolled pain was assessed.