618 results match your criteria Bmj Supportive & Palliative Care[Journal]


Reducing red blood cell folate testing: a case study in utilisation management.

BMJ Open Qual 2019 7;8(1):e000531. Epub 2019 Mar 7.

Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.

Mandatory enrichment of wheat flour in Canada with folic acid since 1998 has caused folate deficiency to be rare. There were 3019 red blood cell (RBC) folate tests performed during an 18-month period at London Health Sciences Centre (LHSC)/St. Joseph's Healthcare London (SJHC) without any folate deficiency detected. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440601PMC

Changing stigmatisation of leprosy: an exploratory, qualitative life course study in Western Nigeria.

BMJ Glob Health 2019 7;4(2):e001250. Epub 2019 Mar 7.

Faculty of Clinical Sciences, Lagos State University, Department of Behavioural Medicine, Ikeja, Nigeria.

Introduction: Renewed interest in health-related stigma has invigorated calls to understand factors and processes underlying stigma. However, few empirical studies explore the influences of structural discrimination and moral status on leprosy-related stigma. We investigated how sociocultural context and organisational policies and practices influenced the connotations of leprosy, sources of stigma and the changing social responses to leprosy in Western Nigeria. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441294PMC

Blood transfusions: time for a change in practice?

Authors:
Elizabeth Brown

BMJ Support Palliat Care 2019 Apr 16. Epub 2019 Apr 16.

Saint Michaels Hospice, Harrogate HG2 8QL, UK

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2019-0017
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http://dx.doi.org/10.1136/bmjspcare-2019-001779DOI Listing
April 2019
1 Read

Trisomy 21 in both fetuses in a DCDA twin pregnancy.

BMJ Case Rep 2019 Apr 14;12(4). Epub 2019 Apr 14.

Obstetrics and Gynecology, National University Hospital, Singapore.

A woman's chances of having a child with Down syndrome increases with age. By age 40, the risk of conceiving a child with Down syndrome is about 1 in 100. We report a rare case of dizygotic dichorionic diamniotic twin pregnancy conceived via in vitro fertilisation, with both twins having trisomy 21. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22760
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http://dx.doi.org/10.1136/bcr-2018-227608DOI Listing
April 2019
2 Reads

Home parenteral nutrition during palliative care: little benefit.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0017
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http://dx.doi.org/10.1136/bmjspcare-2018-001736DOI Listing
April 2019
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Gut-directed hypnotherapy versus standard medical treatment for nausea in children with functional nausea or functional dyspepsia: protocol of a multicentre randomised trial.

BMJ Open 2019 Apr 11;9(4):e024903. Epub 2019 Apr 11.

Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.

Introduction: The treatment of chronic functional nausea or nausea due to functional dyspepsia in children is generally symptomatic. Moreover, these disorders pose a risk for worse psychosocial and health outcomes in children. Hypnotherapy (HT), by its ability to positively influence gastrointestinal and psychosocial functioning, may be an effective treatment for chronic nausea. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02490
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http://dx.doi.org/10.1136/bmjopen-2018-024903DOI Listing
April 2019
1 Read

Enhanced supportive care is broader than palliative care.

BMJ 2019 04 10;365:l1629. Epub 2019 Apr 10.

Royal Surrey County Hospital, Guildford GU2 7XX, UK.

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http://dx.doi.org/10.1136/bmj.l1629DOI Listing

What do families want to improve in the management of paediatric febrile neutropenia during anti-cancer treatment? Report of a patient/public involvement group.

BMJ Paediatr Open 2019 1;3(1):e000398. Epub 2019 Mar 1.

Centre for Reviews and Dissemination, University of York, Leeds, UK.

Background: This study reports how parents and young people who had an experience offebrile neutropenia (FN) improved the design of a trial to inform the management of this condition. Five parents, a young person who had completed treatment and three clinician-researchers contributed.

Methods: The group was formed after an invitation on social media and met via video conference. Read More

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http://dx.doi.org/10.1136/bmjpo-2018-000398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422240PMC

How to strengthen clinical research in Shenzhen, China: qualitative study.

BMJ Open 2019 Apr 3;9(4):e024534. Epub 2019 Apr 3.

Clinical Research Institute, Peking University, Beijing, China.

Objectives: To better understand the strengths and weaknesses, and to propose policy recommendations, regarding conducting high-quality clinical research in Shenzhen, China.

Design: A qualitative study conducted from August to November 2016 using a semistructured interview format involving both focus group interviews and individual interviews.

Setting: Shenzhen, China. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024534DOI Listing

PROgnostic Model for Advanced Cancer (PRO-MAC).

BMJ Support Palliat Care 2019 Apr 4. Epub 2019 Apr 4.

Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore.

Objective: To develop and validate a simple prognostic tool for early prediction of survival of patients with advanced cancer in a tertiary care setting.

Design: Prospective cohort study with 2 years' follow-up.

Setting: Single tertiary teaching hospital in Singapore. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001702DOI Listing
April 2019
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Assessing the quality of health care in the management of bronchiolitis in Australian children: a population-based sample survey.

BMJ Qual Saf 2019 Apr 2. Epub 2019 Apr 2.

Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Background: Bronchiolitis is the most common cause of respiratory hospitalisation in children aged <2 years. Clinical practice guidelines (CPGs) suggest only supportive management of bronchiolitis. However, the availability of CPGs do not guarantee that they are used appropriately and marked variation in the clinical management exists. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-009028DOI Listing
April 2019
2 Reads

Supportive mistletoe therapy in a patient with metastasised neuroblastoma.

BMJ Case Rep 2019 Mar 31;12(3). Epub 2019 Mar 31.

Klinik für Kinder- und Jugendmedizin, Friedrich-Schiller-Universität Jena, Jena, Germany.

Therapies of complementary and alternative medicine (CAM) are used increasingly in paediatric oncology. We present and discuss the influence of supportive mistletoe therapy on factors, such as quality of life, physical ability and performance, and course of disease based on the case of a female patient diagnosed at age 18 with metastasised neuroblastoma, which responded insufficiently to chemotherapy. Read More

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http://dx.doi.org/10.1136/bcr-2018-227652DOI Listing

Vacuum phenomenon in the shoulder of a child.

BMJ Case Rep 2019 Mar 22;12(3). Epub 2019 Mar 22.

Orthopaedics, Queen Elizabeth Hospital, Gateshead, Tyne & Wear, UK.

A 10-year-old boy struck a car bonnet following which his left shoulder got pinned under the wheel. No life-threatening injuries were identified. However, the patient sustained extensive abrasions to the back and the left shoulder, a closed deformity of the left clavicle and a swollen, but stable right knee. Read More

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http://dx.doi.org/10.1136/bcr-2018-226724DOI Listing
March 2019
1 Read

serovar enteritidis peritonitis with spontaneous intestinal perforation in an immunocompetent patient.

BMJ Case Rep 2019 Mar 20;12(3). Epub 2019 Mar 20.

Hopital d'Instruction des Armees Begin, Saint Mande, France.

Few data reported non-typhoidal peritonitis in immunocompromised patients. We reported the case of a man without immunosuppression or predisposing factor, who developed serovar Enteritidis peritonitis with spontaneous intestinal perforation. After emergent surgery, the patient was transferred to intensive care unit (ICU) because of respiratory, renal and haemodynamic failures. Read More

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http://dx.doi.org/10.1136/bcr-2018-228027DOI Listing
March 2019
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Evaluation of inhaled salbutamol effectiveness under supportive use of electrical impedance tomography in ventilated ICU patients: study protocol for a randomised controlled clinical trial.

BMJ Open 2019 Mar 12;9(3):e026038. Epub 2019 Mar 12.

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Germany.

Introduction: The inhalative administration of drugs is a non-invasive application form that is regularly used in the treatment of ventilated patients in critical care setting. However, assessment of effectiveness or distribution of nebulised drugs is one of the lacking cornerstones of modern intensive care monitoring. Electrical impedance tomography (EIT) may provide a promising new monitoring and guiding tool for an adequate optimisation of mechanical ventilation in critically ill patients. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429886PMC
March 2019
2 Reads

Idiopathic omental infarction: managed conservatively.

BMJ Case Rep 2019 Mar 8;12(3). Epub 2019 Mar 8.

Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

We report a case of a 49-year-old woman who presented with acutely worsening episodic abdominal pain. Workup was negative but CT of the abdomen showed right upper quadrant omental fat stranding, suggestive of fat necrosis or infarct. Treatment for the patient was largely supportive with pain management and fluid resuscitation. Read More

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http://dx.doi.org/10.1136/bcr-2018-226978DOI Listing

Serotonin syndrome unmasking thyrotoxicosis.

BMJ Case Rep 2019 Mar 7;12(3). Epub 2019 Mar 7.

Renal/General Medicine, Mercy University Hospital, Cork, Ireland.

A 26-year-old cachectic man presented with an altered mental status. He was agitated, tremulous, hyperthermic and diaphoretic with largely dilated pupils. Collateral history revealed acute ingestion of 3,4-methylenedioxymethamphetamine on a background of chronic drug abuse. Read More

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http://dx.doi.org/10.1136/bcr-2018-228404DOI Listing
March 2019
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Cohort study of healthcare use, costs and diagnoses from onset to 6 months after discharge for takotsubo syndrome in Sweden.

BMJ Open 2019 Mar 1;9(2):e027814. Epub 2019 Mar 1.

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Objective: Little is known about the economic impact of takotsubo syndrome (TS) for patients and the health system after initial discharge from hospital. Therefore, the aim of this study was to describe the healthcare resource use and calculate direct healthcare costs for TS, from hospitalisation to 6 months after discharge, and explore the distribution of costs between TS and other diagnoses among patients with TS.

Method, Participants And Setting: Cohort study investigating direct healthcare costs from hospitalisation, open specialised outpatient and primary care. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02781
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http://dx.doi.org/10.1136/bmjopen-2018-027814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398620PMC
March 2019
2 Reads

Targeted therapies for previously treated advanced or metastatic renal cell carcinoma: systematic review and network meta-analysis.

BMJ Open 2019 Mar 1;9(3):e024691. Epub 2019 Mar 1.

British Medical Journal Technology Assessment Group (BMJ-TAG), BMA House, London, UK.

Objective: To compare the effectiveness and safety of treatments for advanced or metastatic renal cell carcinoma (amRCC) after treatment with vascular endothelial growth factor (VEGF)-targeted treatment.

Design: Systematic review and network meta-analysis of randomised controlled trials (RCTs) and comparative observational studies. MEDLINE, EMBASE and Cochrane Library were searched up to January 2018. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429896PMC
March 2019
2 Reads

Impact of medical assistance in dying (MAiD) on family caregivers.

BMJ Support Palliat Care 2019 Mar 1. Epub 2019 Mar 1.

Supportive Care, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada

Medical assistance in dying (MAiD) is a globally polarising topic which often sparks debate surrounding the ethical and moral dilemmas that arise with a life-ending intervention. To gain a better understanding of this intervention, it is important to explore the experience of those most intimately affected by MAiD. Family caregivers of those with a terminal illness are the backbone of the healthcare and support team, often providing a substantial amount of informal care while at the same time coping with their own distress and anticipatory grief. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001686DOI Listing
March 2019
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Diagnostics for Nipah virus: a zoonotic pathogen endemic to Southeast Asia.

BMJ Glob Health 2019 1;4(Suppl 2):e001118. Epub 2019 Feb 1.

Foundation for Innovative New Diagnostics (FIND), Emerging Threats Programme, Geneva, Switzerland.

Nipah virus (NiV) is an emerging pathogen that, unlike other priority pathogens identified by WHO, is endemic to Southeast Asia. It is most commonly transmitted through exposure to saliva or excrement from the fruit bat, or direct contact with intermediate animal hosts, such as pigs. NiV infection causes severe febrile encephalitic disease and/or respiratory disease; treatment options are limited to supportive care. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361328PMC
February 2019
3 Reads

An updated roadmap for MERS-CoV research and product development: focus on diagnostics.

BMJ Glob Health 2019 1;4(Suppl 2):e001105. Epub 2019 Feb 1.

Health Emergencies Programme, WHO, Geneva, Switzerland.

Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. In this review we identified sources for molecular and serological diagnostic tests used in MERS-CoV detection, case management and outbreak investigations, as well as surveillance for humans and animals (camels), and summarised the performance of currently available tests, diagnostic needs, and associated challenges for diagnostic test development and implementation. A more detailed understanding of the kinetics of infection of MERS-CoV is needed in order to optimise the use of existing assays. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361340PMC
February 2019
1 Read

Impact of a mass media campaign on participation rates in a National Bowel Cancer Screening Program: a field experiment.

BMJ Open 2019 Jan 25;9(1):e024267. Epub 2019 Jan 25.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.

Objectives And Design: This field experiment aimed to compare bowel cancer screening participation rates prior to, during and after a mass media campaign promoting screening, and the extent to which a higher intensity campaign in one state led to higher screening rates compared with another state that received lower intensity campaign exposure.

Intervention: An 8-week television-led mass media campaign was launched in selected regions of Australia in mid-2014 to promote Australia's National Bowel Cancer Screening Program (NBCSP) that posts out immunochemical faecal occult blood test (iFOBT) kits to the homes of age-eligible people. The campaign used paid 30-second television advertising in the entire state of Queensland but not at all in Western Australia. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347911PMC
January 2019
2 Reads

Haematologists and palliative care: a multicentric qualitative study.

BMJ Support Palliat Care 2019 Feb 26. Epub 2019 Feb 26.

Palliative Care, Hospices Civils de Lyon, Lyon, France.

Objectives: Early palliative care leads to meaningful improvements in physical and psychosocial symptoms, as well as quality of life, in patients with advanced cancer. Patients with haematological malignancies, despite a high level of distress, continue to have less access to palliative care services. The aim of this study was to identify haematologists' perceptions of palliative care, as well as barriers to patient referral. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001714DOI Listing
February 2019
1 Read

Utility of the number needed to treat in paediatric haematological cancer randomised controlled treatment trials: a systematic review.

BMJ Open 2019 Feb 20;9(2):e022839. Epub 2019 Feb 20.

School Of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.

Objectives: The primary objective was to assess the utility of the number needed to treat (NNT) to inform decision-making in the context of paediatric oncology and to calculate the NNT in all superiority, parallel, paediatric haematological cancer, randomised controlled trials (RCTs), with a comparison to the threshold NNT as a measure of clinical significance.

Design: Systematic review DATA SOURCES: MEDLINE, EMBASE and the Cochrane Childhood Cancer Group Specialized Register through CENTRAL from inception to August 2018.

Eligibility Criteria For Selecting Studies: Superiority, parallel RCTs of haematological malignancy treatments in paediatric patients that assessed an outcome related to survival, relapse or remission; reported a sample size calculation with a delta value to allow for calculation of the threshold NNT, and that included parameters required to calculate the NNT and associated CI. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398916PMC
February 2019
1 Read

Selective citation in the literature on the hygiene hypothesis: a citation analysis on the association between infections and rhinitis.

BMJ Open 2019 Feb 19;9(2):e026518. Epub 2019 Feb 19.

Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, Maastricht, Limburg, The Netherlands.

Objective: Our objective was to assess the occurrence and determinants of selective citation in scientific publications on Strachan's original hygiene hypothesis. His hypothesis states that lack of exposure to infections in early childhood increases the risk of rhinitis.

Setting: Web of Science Core Collection. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377569PMC
February 2019
3 Reads

Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey.

BMJ Open 2019 Feb 19;9(2):e020608. Epub 2019 Feb 19.

Department of Internal Medicine, College of Health Sciences, The University of Dodoma, Dodoma, United Republic of Tanzania.

Objective: This study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors.

Design: Health facility-based cross-sectional survey.

Setting: We analysed data for obstetric and newborn care services obtained from the 2014-2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-020608DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398731PMC
February 2019
1 Read
2.063 Impact Factor

Qualitative study to elicit patients' and primary care physicians' perspectives on the use of a self-management mobile health application for knee osteoarthritis.

BMJ Open 2019 Feb 1;9(1):e024016. Epub 2019 Feb 1.

Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.

Objective: To elicit perspectives of family physicians and patients with knee osteoarthritis (KOA) on KOA, its treatment/management and the use of a mobile health application (app) to help patients self-manage their KOA.

Design: A qualitative study using Cognitive Task Analysis for physician interviews and peer-to-peer semistructured interviews for patients according to the Patient and Community Engagement Research (PaCER) method.

Setting: Primary care practices and patient researchers at an academic centre in Southern Alberta. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361338PMC
February 2019
2 Reads

Lung Cancer App (LuCApp) study protocol: a randomised controlled trial to evaluate a mobile supportive care app for patients with metastatic lung cancer.

BMJ Open 2019 Feb 15;9(2):e025483. Epub 2019 Feb 15.

Centre for Research in Health and Social Care Management (CERGAS), SDA Bocconi, Milano, Italy.

Introduction: Mobile health technologies may enhance patient empowerment and data integration along the whole care continuum. However, these interventions pose relatively new regulatory, organisational and technological challenges that limit appropriate evaluation. Lung Cancer App (LuCApp) is a mobile application developed by researchers and clinicians to promote real-time monitoring and management of patients' symptoms. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398637PMC
February 2019
1 Read

Conversion of other opioids to methadone: a retrospective comparison of two methods.

BMJ Support Palliat Care 2019 Feb 16. Epub 2019 Feb 16.

Department of Supportive and Palliative Care, Mater Health Services, Brisbane, Queensland, Australia

Context: A rapid method of methadone conversion known as the Perth Protocol is commonly used in Australian palliative care units. There has been no follow-up or validation of this method and no comparison between different methods of conversion.

Objectives: The primary objective of this study was to test the hypothesis that the achieved doses of methadone are independent of the conversion method (rapid vs slower). Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001645DOI Listing
February 2019
2 Reads

Multicomponent non-pharmacological intervention to prevent delirium for hospitalised people with advanced cancer: study protocol for a phase II cluster randomised controlled trial.

BMJ Open 2019 Jan 28;9(1):e026177. Epub 2019 Jan 28.

IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia.

Introduction: Delirium is a significant medical complication for hospitalised patients. Up to one-third of delirium episodes are preventable in older inpatients through non-pharmacological strategies that support essential human needs, such as physical and cognitive activity, sleep, hydration, vision and hearing. We hypothesised that a multicomponent intervention similarly may decrease delirium incidence, and/or its duration and severity, in inpatients with advanced cancer. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352777PMC
January 2019
4 Reads

Paediatric presentation of intracranial haemorrhage due to thrombosis of a developmental venous anomaly.

BMJ Case Rep 2019 Jan 17;12(1). Epub 2019 Jan 17.

Neurosurgery, Albany Medical Center, Albany, New York, USA.

Developmental venous anomalies (DVAs) are the most commonly encountered cerebral malformations. While generally asymptomatic and discovered as incidental findings, there is a small number that can cause intracranial haemorrhage, usually attributed to associated cavernomas; however, venous thrombosis of the draining vein is a rare cause. A 10-year-old woman presented with seizure episodes. Read More

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http://dx.doi.org/10.1136/bcr-2018-227362DOI Listing
January 2019
3 Reads

Recent advances in understanding and managing acute pancreatitis.

F1000Res 2018 28;7. Epub 2018 Jun 28.

Division of Gastroenterology and Hepatology, University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA.

This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. Read More

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http://dx.doi.org/10.12688/f1000research.14244.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039949.2PMC
June 2018
9 Reads

Healthcare professionals' moral distress in adult palliative care: a systematic review.

BMJ Support Palliat Care 2019 Jan 12. Epub 2019 Jan 12.

Psychology Unit of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.

Objectives: Palliative care providers may be exposed to numerous detrimental psychological and existential challenges. Ethical issues in the healthcare arena are subject to continual debate, being fuelled with ongoing medical, technological and legal advancements. This work aims to systematically review studies addressing the moral distress experienced by healthcare professionals who provide adult palliative care. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001674DOI Listing
January 2019

Changing the norms that drive intimate partner violence: findings from a cluster randomised trial on what predisposes bystanders to take action in Kampala, Uganda.

BMJ Glob Health 2018 14;3(6):e001109. Epub 2018 Dec 14.

Raising Voices, Kampala, Uganda.

Introduction: Despite widespread calls to end violence against women, there remains limited evidence on how to prevent it. Community-level programmes seek to engage all levels of the community in changing norms that drive intimate partner violence (IPV). However, little is known about what predisposes ordinary people to become active in violence prevention. Read More

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http://gh.bmj.com/lookup/doi/10.1136/bmjgh-2018-001109
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http://dx.doi.org/10.1136/bmjgh-2018-001109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304103PMC
December 2018
9 Reads

Efficacy of a guided internet-based intervention (iSOMA) for somatic symptoms and related distress in university students: study protocol of a randomised controlled trial.

BMJ Open 2018 Dec 31;8(12):e024929. Epub 2018 Dec 31.

Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Institute of Psychology, University of Mainz, Mainz, Germany.

Introduction: Persistent and distressing somatic symptoms are common in younger age cohorts such as university students. However, the majority does not receive adequate psychosocial care. Internet-based and mobile-based interventions may represent low threshold and effective extensions to reduce somatic and associated mental symptom severity. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318514PMC
December 2018

Best supportive care in advanced lung cancer-more than a label?

BMJ 2018 Dec 27;363:k5017. Epub 2018 Dec 27.

Edinburgh Napier University, Edinburgh, UK.

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http://dx.doi.org/10.1136/bmj.k5017DOI Listing
December 2018

Lingual liability: macroglossia and dyspnoea as the harbinger of systemic AL (light-chain) cardiac amyloidosis.

BMJ Case Rep 2018 Dec 22;11(1). Epub 2018 Dec 22.

Division of Cardiology, Tripler Army Medical Center, Tripler, Hawaii, USA.

A 58-year-old man presented with a chief complaint of tongue indentations and discomfort. Otolaryngology treated him for oral thrush with counselling to avoid tongue biting. In addition, the patient reported dyspnoea described as a decrease in tolerance of his physical activities. Read More

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http://dx.doi.org/10.1136/bcr-2018-225923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307669PMC
December 2018
4 Reads

Tumour lysis syndrome following eribulin for metastatic uterine leiomyosarcoma.

BMJ Case Rep 2018 Dec 19;11(1). Epub 2018 Dec 19.

Department of Hematology and Oncology, University of Florida, Gainesville, Florida, USA.

A middle-aged woman with a history of leiomyosarcoma of the uterus treated with surgery and adjuvant chemotherapy suffered a bulky metastatic recurrence 1 year later. She elected treatment with palliative eribulin, presenting with acute renal failure and electrolyte abnormalities consistent with tumour lysis syndrome on cycle 1 day 8. Despite aggressive supportive care and treatment including intravenous hydration, bicarbonate and rasburicase, she continued to decline, ultimately foregoing haemodialysis in favour of palliative care and passed away in the hospital. Read More

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http://dx.doi.org/10.1136/bcr-2018-224576DOI Listing
December 2018
2 Reads

Thyroid storm: a case of haemodynamic failure promptly reversed by aggressive medical therapy with antithyroid agents and steroid pulse.

BMJ Case Rep 2018 Dec 14;11(1). Epub 2018 Dec 14.

Intensive Care Unit, Centro Hospitalar do Médio Tejo EPE, Unidade de Abrantes, Abrantes, Santarém, Portugal.

Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. Read More

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http://dx.doi.org/10.1136/bcr-2018-226669DOI Listing
December 2018
3 Reads

Use of platelet and erythroid growth factors during induction chemotherapy for acute lymphoblastic leukaemia in a Jehovah's Witness.

BMJ Case Rep 2018 Dec 7;11(1). Epub 2018 Dec 7.

Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA.

We present a 21-year-old woman diagnosed with Philadelphia (Ph) chromosome-like CD20 positive B-cell acute lymphoblastic leukaemia (ALL). She was a Jehovah's Witness (JW) and declined all blood product transfusion support. She was initiated on the CALGB 10403 chemotherapy protocol for her ALL. Read More

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http://dx.doi.org/10.1136/bcr-2018-226497DOI Listing
December 2018

Neuroleptic malignant-like syndrome causing thrombocytopaenia: a rare association.

BMJ Case Rep 2018 Dec 3;11(1). Epub 2018 Dec 3.

Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Neuroleptic malignant-like syndrome is a rare but potentially fatal complication of sudden withdrawal of dopaminergic drugs. Clinical features are similar to that of neuroleptic malignant syndrome (NMS) like hyperthermia, autonomic dysfunction, altered sensorium, muscle rigidity; but instead of history of neuroleptic use, there is history of withdrawal of dopaminergic drugs. Laboratory examination generally show elevated creatine phosphokinase levels and may show elevated total leucocyte count. Read More

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http://www.bmj.com/lookup/doi/10.1136/bcr-2018-227089
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http://dx.doi.org/10.1136/bcr-2018-227089DOI Listing
December 2018
5 Reads

Acute mountain sickness (AMS) in a Nepali pilgrim after rapid ascent to a sacred lake (4380 m) in the Himalayas.

BMJ Case Rep 2018 Dec 3;11(1). Epub 2018 Dec 3.

Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.

A 55-year-old female Nepali pilgrim presented to the Himalayan Rescue Association Temporary Health Camp near the sacred Gosainkund Lake (4380 m) north of Kathmandu, Nepal, with a complaint of severe headache, vomiting and light-headedness. She was diagnosed with severe acute mountain sickness. Intramuscular dexamethasone was administered. Read More

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http://dx.doi.org/10.1136/bcr-2017-222888DOI Listing
December 2018

Metformin-associated lactic acidosis precipitated by liraglutide use: adverse effects of aggressive antihyperglycaemic therapy.

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Department of Internal Medicine, Pulmonary and Critical Care, University of Texas Southwestern, Dallas, Texas, USA.

Older patients with type 2 diabetes are prone to developing adverse events with aggressive antihyperglycaemic therapy. Metformin-associated lactic acidosis (MALA) is one such rare, life-threatening adverse drug effect. We report the case of a 70-year-old man with a glycated haemoglobin of 7. Read More

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http://dx.doi.org/10.1136/bcr-2018-227102DOI Listing
November 2018
1 Read

Unusual case of Lemierre's syndrome.

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Infectious diseases, Hospital for Tropical Diseases, London, UK.

A young previously healthy patient presented with sepsis and cavitating pneumonia. was isolated from blood cultures and subsequent CT neck showed an internal jugular vein thrombosis. Treatment was with antibiotics, anticoagulation and supportive management. Read More

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http://dx.doi.org/10.1136/bcr-2018-226948DOI Listing
November 2018
3 Reads

Evaluation of stakeholder views on peer review of NIHR applications for funding: a qualitative study.

BMJ Open 2018 Dec 14;8(12):e022548. Epub 2018 Dec 14.

Wessex Institute, University of Southampton, Southampton, UK.

Objectives: Innovations resulting from research have both national and global impact, so selecting the most promising research studies to fund is crucial. Peer review of research funding applications is part of the selection process, and requires considerable resources. This study aimed to elicit stakeholder opinions about which factors contribute to and influence effective peer review of funding applications to the UK National Institute for Health Research (NIHR), and to identify possible minor improvements to current processes and any major changes or potential innovations to achieve a more efficient peer review process. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303555PMC
December 2018

Evaluation of a toolkit resource package to support positive workplace behaviours in relation to quality end-of-life care in Australian hospitals.

BMJ Open Qual 2018 10;7(4):e000286. Epub 2018 Nov 10.

Palliative and Supportive Services, Flinders University Faculty of Medicine, School of Health Sciences, Adelaide, South Australia, Australia.

Background: The study aimed to determine the effectiveness of an action-orientated toolkit in supporting behaviour change in relation to quality end-of-life care in acute hospital settings. The toolkit was developed to complement a programme of online end-of-life care education.

Methods: A toolkit was developed from an international review of peer-reviewed literature on end of life. Read More

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http://dx.doi.org/10.1136/bmjoq-2017-000286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231109PMC
November 2018
2 Reads

The Kidney Supportive Care programme: characteristics of patients referred to a new model of care.

BMJ Support Palliat Care 2018 Dec 4. Epub 2018 Dec 4.

School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.

Objectives: For many people with advanced kidney disease, their physical, psychological and emotional needs remain unmet. Kidney supportive care, fully integrating specialist kidney and palliative care teams, responds to the emotional and symptom distress in this cohort who may be on a non-dialysis care pathway or on dialysis and approaching end of life. We aimed to analyse and describe the operation and patient characteristics of a new kidney supportive care programme (KSCp). Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001630DOI Listing
December 2018
10 Reads

Disability status, intimate partner violence and perceived social support among married women in three districts of the Terai region of Nepal.

BMJ Glob Health 2018 31;3(5):e000934. Epub 2018 Oct 31.

Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

Introduction: Women living with disabilities are disproportionately vulnerable to intimate partner violence (IPV). Existing research on the topic largely takes place in high-income settings and treats disability as a dichotomous experience-an individual either has a disability or does not. Disability experiences, however, are diverse such that some individuals face minimal impairment, while for others impairment can be severe. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-000934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231095PMC
October 2018

Barriers to specialist palliative care in interstitial lung disease: a systematic review.

BMJ Support Palliat Care 2018 Nov 21. Epub 2018 Nov 21.

Norwich Medical School, University of East Anglia, Norwich, UK.

Background: Current guidelines recommend palliative care based on individual needs for patients with idiopathic pulmonary fibrosis. However, patients with interstitial lung disease (ILD) are less likely to receive specialist palliative care services compared with patients with malignant disease. The aim of this review is to summarise recent studies addressing barriers to referring patients to specialist palliative care services. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001575DOI Listing
November 2018
26 Reads