Many patients with cancer require palliative care at some stage and the vast majority of people followed in palliative care are cancer patients. Patients with cancer are at high risk of venous thromboembolism (VTE), and this is particularly true during the advanced palliative phase when mobility is limited or absent. Patients with cancer in palliative care are at higher bleeding risk compared to non-cancer patients. Decisions to treat VTE or withhold anticoagulation for these patients have proven to be difficult and depend largely on an individual clinician's judgment. For this reason, we have developed a consensus proposal for appropriate management of cancer-associated thromboembolism (CAT) in patients in palliative care, which is presented in this article. The proposal was informed by the recent scientific literature retrieved through a systematic literature review. In cancer patients in advanced palliative care, the benefit/risk ratio of anticoagulation seems unfavourable with a higher haemorrhagic risk than the benefit associated with prevention of CAT recurrence and, above all, in the absence of any benefit on quality of life. For this reason, we recommend that patients should be prescribed anticoagulants on a case-by-case basis. The choice of whether to treat, and with which type of treatment, should take into account anticipated life expectancy and patient preferences, as well as clinical factors such as the estimated bleeding risk, the type of VTE experienced and the time since the VTE event.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.revmed.2024.06.001 | DOI Listing |
Lancet Reg Health Eur
March 2025
Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
Background: Ultra-processed food (UPF) consumption has been linked with higher risk of mortality. This multi-centre study investigated associations between food intake by degree of processing, using the Nova classification, and all-cause and cause-specific mortality.
Methods: This study analyzed data from the European Prospective Investigation into Cancer and Nutrition.
J Geriatr Emerg Med
December 2024
Geriatric Research Education and Clinic Center, James J. Peters VA Medical Center, 130 W Kingsbridge Rd, Bronx, NY 10468 & Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029.
Background: Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs.
View Article and Find Full Text PDFMedEdPORTAL
January 2025
Associate Professor, Division of Palliative Medicine, Department of Family Medicine, Robert Larner, M.D., College of Medicine at the University of Vermont.
Introduction: Stigmatizing attitudes held by health care professionals against individuals with substance use disorder (SUD) result in worse clinical outcomes. Story-listening has been shown to help mitigate bias for medical trainees. We created a narrative-based small-group facilitated discussion between medical students and an individual in recovery from SUD through a direct partnership with a community peer-recovery organization.
View Article and Find Full Text PDFRev Cardiovasc Med
January 2025
Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine, Pain and Palliative Therapy, Asklepios Klinikum Harburg, 21075 Hamburg, Germany.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide, with a low survival rate of around 7% globally. Key factors for improving survival include witnessed arrest, bystander cardiopulmonary resuscitation (CPR), and early defibrillation. Despite guidelines advocating for the "chain of survival", bystander CPR and defibrillation rates remain suboptimal.
View Article and Find Full Text PDFCureus
December 2024
Physical Medicine and Rehabilitation, San Joaquin Valley Rehabilitation Hospital, Fresno, USA.
Transverse myelitis (TM), a poorly understood neurological disorder, can manifest in various clinical scenarios. We report a unique case where TM presented in a background of benign paroxysmal positional vertigo (BPPV). The patient, an otherwise healthy female, experienced a rapid onset of symptoms, culminating in complete left-sided hemiparesis and exacerbation of BPPV characteristics.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!