Expression of existential suffering in two patients with advanced cancer in an acute palliative care unit.

Background: Recognizing and managing existential suffering remains challenging. We present two cases demonstrating how existential suffering manifests in patients and how to manage it to alleviate suffering.

Case Description: Case 1: A 69-year-old man with renal cell carcinoma receiving end-of-life care expressed fear of lying down "as he may not wake up.

Connectome mapping with edge density imaging differentiates pediatric mild traumatic brain injury from typically developing controls: proof of concept.

Background: Although acute neurologic impairment might be transient, other long-term effects can be observed with mild traumatic brain injury. However, when pediatric patients with mild traumatic brain injury present for medical care, conventional imaging with CT and MR imaging often does not reveal abnormalities.

Objective: To determine whether edge density imaging can separate pediatric mild traumatic brain injury from typically developing controls.

Patterns of Opioid Prescription, Use, and Costs Among Patients With Advanced Cancer and Inpatient Palliative Care Between 2008 and 2014.

Purpose: An understanding of opioid prescription and cost patterns is important to optimize pain management for patients with advanced cancer. This study aimed to determine opioid prescription and cost patterns and to identify opioid prescription predictors in patients with advanced cancer who received inpatient palliative care (IPC).

Materials And Methods: We reviewed data from 807 consecutive patients with cancer who received IPC in each October from 2008 through 2014.

Frequency, Outcomes, and Associated Factors for Opioid-Induced Neurotoxicity in Patients with Advanced Cancer Receiving Opioids in Inpatient Palliative Care.

Opioid-induced neurotoxicity (OIN) is an underdiagnosed yet distressing symptom in palliative care patients receiving opioids. However, there have been only a limited number of studies on OIN. Our aim was to determine the frequency of and risk factors for OIN in patients receiving opioids during inpatient palliative care.

Trainee inexperience is associated with longer procedure times but no increase in complications for cardiac device implantation.

Background: The "July phenomenon" describes poor patient outcomes in teaching hospitals at the beginning of a new academic year when trainees begin. Whether this phenomenon truly exists is unclear.

Objective: The purpose of this study was to identify whether trainee and attending inexperience is associated with cardiac electrophysiologic procedural outcomes including total procedure time, fluoroscopy time, and complications.

Risk factors and prognosis for clot formation on cardiac device leads.

Background: Clot formation on cardiac device leads is poorly understood. We sought to determine how often clot is seen on device leads by transthoracic echo (TTE), identify risk factors, and to describe the natural history of this phenomenon.

Methods: We reviewed 71,888 echocardiographic studies performed at the University of California, San Francisco from 2005 to 2011.