Palliative Care Utilization Among Hospitalized Patients With Common Chronic Conditions in the United States.

Limited data exist around the receipt of palliative care (PC) in patients hospitalized with common chronic conditions. We studied the independent predictors, temporal trends in rates of PC utilization in patients hospitalized with acute exacerbation of common chronic diseases. Population-based cohort study of all hospitalizations with an acute exacerbation of heart disease (HD), cerebrovascular accident (CVA), cancer (CA), and chronic lower respiratory disease (CLRD).

Perinatal deaths and low birthweight in an urban health centre in the Gambia: A prospective cohort study.

Perinatal deaths (stillbirths after 28 weeks gestation and early neonatal deaths) are rarely reported separately but are the deaths most closely associated with complications during pregnancy, birth and the first days of life. We conducted a prospective cohort study to report perinatal deaths, late neonatal deaths and low birthweight babies as they occur. This cohort of birth outcomes from The Gambia was conducted between 2012 and 2016 and followed 1611 women attending a government-supported health center from the first antenatal visit to 28 days post-delivery.

Warfarin-induced deep vein thrombosis.

We are presenting a 72-year-old female who was admitted to hospital with deep vein thrombosis (DVT). She was known to have atrial fibrillation and was initiated on warfarin for stroke prophylaxis 3 days earlier. She was given warfarin therapy without low molecular weight heparin cover as per "slow-start regimen" protocol.

An unusual presentation of an amoebic liver abscess: the story of an unwanted souvenir.

This case was rather unusual with regard to the disease presentation. The patient had non-specific symptoms of weight loss and general malaise, without any history of preceding diarrhoea or dysentery. It is important to be aware of the epidemiology of the disease, and to relate it to patients presenting with symptoms suggestive of amoebiasis.

Bilateral recurrent wrist flexor tenosynovitis and rice body formation in a patient with sero-negative rheumatoid arthritis: A case report and review of literature.

Introduction: Rice body formation has been traditionally observed in the joint and tendon sheaths of patients with tuberculosis. Few case reports exist that describe rice body formation in patients with rheumatoid arthritis. We describe a case report of bilateral recurrent wrist flexor tenosynovitis with rice body formation in a patient with sero-negative rheumatoid arthritis.

Survival after short- or long-term ventilation after acute spinal cord injury: a single-centre 25-year retrospective study.

Study Design: A retrospective review of acute spinal cord injury patients having assisted ventilation on or after admission between 1981 and 2005.

Objective: To assess survival after acute ventilatory support.

Setting: Northwest Regional Spinal Injuries Centre, Southport, England.

Influence of type of management of transverse sacral fractures on neurological outcome. A case series and review of literature.

Study Design: A retrospective study with review of literature.

Objectives: (1) To report the management and outcome of a series of six cases of transverse sacral fractures. (2) To review the literature and see the influence of the type of treatment on the neurological outcome, in particular, of the bladder and bowel and to identify the possible factors determining this outcome.

A hidden injury.

Transverse sacral fractures associated with cauda equina syndrome are uncommon lesions and often missed at the time of presentation. This case report highlights the benign presentation and the unpleasant outcome of such an injury.

Uterine perforation by GyneFix frameless IUD: two case reports.

Two cases of uterine perforation are described, occurring 11 days and 4 months, respectively, after the insertion of GyneFix, a frameless intra-uterine contraceptive device (IUD). In both the cases initial ultrasound scan showed the intra-uterine position of the device. Removal of the IUD, either by laparoscopy or laparotomy, had to be carried out.

Aeromonas hydrophila wound infection in elective surgery.

Patients with diabetes mellitus are subject to wound infection with unusual pathogens. A patient who had colonic surgery developed Aeromonas hydrophila wound infection, which mainly results from contamination by water or soil.

Gastrointestinal autonomic nerve sarcoma presenting as a giant intra-abdominal cyst.

Gastrointestinal autonomic nerve sarcomas are rare tumours. A 36-year-old man presented with abdominal pain, distension and constipation. Abdominal ultrasound and CT scanning demonstrated a giant cystic intra-abdominal mass.

Fatal intestinal perforation secondary to fragmentation of a Celestin tube.

Background/aims: Oesophageal intubation remains one of the principal methods of palliation for an obstructing oesophageal carcinoma. We present a case which illustrates a rare but fatal complication of this procedure.

Methods: A 60-year-old female with oesophageal cancer presented with total dysphagia 9 months following insertion of a Celestin tube for palliation.

Looking into the factors affecting renal patients' quality of life.

Quality of life, according to Horquist is "the extent to which one's needs are satisfied, in the context of physical, psychological, social and environmental conditions" (I). Self-esteem is the basic element of a good quality of life. Health-related quality of life consists of a number of components; including family relationships, friendships, finances, physical and psychological status, adjustment to therapy and feeling of security during the treatment.

The effect of insufflation leaks in long-term ventilation. Waking and sleeping transcutaneous gas tensions in ventilator-dependent patients with an uncuffed tracheostomy tube.

Transcutaneous blood gases were recorded for 60 min when awake and asleep in 10 ventilator-dependent patients with high tetraplegia who used a pressure-limited ventilator and uncuffed tracheostomy tube. The mean arterial oxygen tension awake was 16.0 kPa compared with 15.

The effect of insufflation leaks upon ventilation. A quantified comparison of ventilators.

Some ventilator-dependent patients use uncuffed tracheostomy tubes, resulting in fluctuations in the minute volume of ventilation. Bedside measurement of ventilation is difficult because of the insufflation and exsufflation leaks. This laboratory study of five different ventilators measured the tidal volumes achieved with three insufflation leaks introduced in an increasing order of magnitude and at three levels of compliance.

Recommendations concerning the costing and management for patients requiring domiciliary ventilation.

Reinstallation back in their own homes of severely disabled people who are ventilator dependent is increasingly becoming a viable trend. Such a development calls for detailed and imaginative planning and negotiations with several agencies. More than a decade of experience in Southport has highlighted the need for early and comprehensive negotiations to ensure that these profoundly disabled people are not denied a quality of life to which they are entitled and which advances in technology has made possible.

Applying functional analysis to psychological rehabilitation following spinal cord injury.

There have been numerous attempts to categorize the responses of individuals to spinal trauma on the basis of generalized stage theories of grief reaction, and personality theory. A number of these studies are critically appraised and a behavioral model, based on functional analysis, is proposed as a more constructive framework for future research. Such an approach is applied clinically to the activities and development of the Clinical Psychology Service provided to the Mersey Regional Spinal Injuries Centre in Southport, England.