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Upper arm movements in the last days of life: A new possible sign of impending death.
Palliat Support Care
January 2025
Faculdade de Medicina da Universidade de Coimbra, Universidade de Coimbra, Coimbra, Portugal.
One of the most crucial stages of palliative care is the last days and hours of life, which require special attention and knowledgeable identification of clinical signs described as signs of impending death (SID). Our case series of 11 patients receiving home palliative care describes bilateral hypoactive, stereotyped upper arm movements (scratching of the head, forehead, and nose) that were previously unknown or described, often accompanied by SID.
View Article and Find Full Text PDF[Palliative care : not wait for the end of life].
Rev Med Suisse
January 2025
Service de médecine palliative, Hôpitaux universitaires de Genève, 1211 Genève 14.
Patients with serious illnesses wish to maintain their autonomy and decide the course of their end of life. The role of healthcare professionals is to assess the patient's understanding of their illness, help them become aware of the progression of their condition, and adapt these conversations according to the patient's emotional state, while providing regular spaces for discussion. Some patients continue to have expectations that may seem unrealistic despite a limited prognosis.
View Article and Find Full Text PDFSurgical portfolios: A systematic scoping review.
Surg Pract Sci
September 2022
SingHealth Duke-NUS Breast Centre, Singapore General Hospital, Outram Road 169608 Singapore.
Introduction: The need for longitudinal and comprehensive evidenced development of surgical knowledge, skills and attitudes, and the attainment of appropriate competencies have spotlighted portfolio use. Yet variations in structure, content and roles as well as its resource-heavy reputation have limited its impact. The purpose of this study is to map prevailing data on the use of portfolios in postgraduate surgical education to address a lack of e-portfolio use and guide its design and structuring in surgery.
View Article and Find Full Text PDFOptimal Machine Learning Models for Developing Prognostic Predictions in Patients With Advanced Cancer.
Cureus
December 2024
Mathematics, Keio University, Yokohama, JPN.
Context: Accurate prognosis prediction for cancer patients in palliative care is critical for clinical decision-making and personalized care. Traditional statistical models have been complemented by machine learning approaches; however, their comparative effectiveness remains underexplored.
Objectives: To assess the prognostic accuracy of statistical and machine learning models in predicting 30-day survival in patients with advanced cancer using objective data, such as the result of the blood test.
Persistent Thrombocytopenia of an Unexplained Cause in a Patient With Metastatic Renal Cell Carcinoma: A Case Report.
Cureus
December 2024
Surgical Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, IND.
Thrombocytopenia is a common complication in patients with solid tumors, particularly renal cell carcinoma (RCC), arising from mechanisms such as chemotherapy, direct tumor invasion, and paraneoplastic syndromes. Managing thrombocytopenia in advanced cancer presents significant challenges, often limiting therapeutic options and impacting patient outcomes. This case report describes a 62-year-old man with metastatic RCC complicated by persistent thrombocytopenia, unresponsive to both conventional treatments and novel therapies.
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