Terminally Ill: Persons with an incurable or irreversible illness at the end stage that will result in death within a short time. (From O'Leary et al., Lexikon: Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform, 1994, p780)Critical Illness: A disease or state in which death is possible or imminent.Mentally Ill Persons: Persons with psychiatric illnesses or diseases, particularly psychotic and severe mood disorders.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Louping Ill: An acute tick-borne arbovirus infection causing meningoencephalomyelitis of sheep.Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.APACHE: An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.Intensive Care Units, Pediatric: Hospital units providing continuous surveillance and care to acutely ill infants and children. Neonates are excluded since INTENSIVE CARE UNITS, NEONATAL is available.Sepsis: Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.Respiration, Artificial: Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).Commitment of Mentally Ill: Legal process required for the institutionalization of a patient with severe mental problems.Acute Kidney Injury: Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Multiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative.Terminal Care: Medical and nursing care of patients in the terminal stage of an illness.Monitoring, Physiologic: The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.Hemofiltration: Extracorporeal ULTRAFILTRATION technique without HEMODIALYSIS for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function.Renal Replacement Therapy: Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys.Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes.Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include FLUID THERAPY which normalizes body fluids to restore WATER-ELECTROLYTE BALANCE.Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Deinstitutionalization: The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Attitude to Death: Conceptual response of the person to the various aspects of death, which are based on individual psychosocial and cultural experience.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Shock: A pathological condition manifested by failure to perfuse or oxygenate vital organs.Delirium: A disorder characterized by CONFUSION; inattentiveness; disorientation; ILLUSIONS; HALLUCINATIONS; agitation; and in some instances autonomic nervous system overactivity. It may result from toxic/metabolic conditions or structural brain lesions. (From Adams et al., Principles of Neurology, 6th ed, pp411-2)Systemic Inflammatory Response Syndrome: A systemic inflammatory response to a variety of clinical insults, characterized by two or more of the following conditions: (1) fever >38 degrees C or HYPOTHERMIA 90 beat/minute; (3) tachypnea >24 breaths/minute; (4) LEUKOCYTOSIS >12,000 cells/cubic mm or 10% immature forms. While usually related to infection, SIRS can also be associated with noninfectious insults such as TRAUMA; BURNS; or PANCREATITIS. If infection is involved, a patient with SIRS is said to have SEPSIS.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Euthanasia: The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)Right to Die: The right of the patient or the patient's representative to make decisions with regard to the patient's dying.Suicide, Assisted: Provision (by a physician or other health professional, or by a family member or friend) of support and/or means that gives a patient the power to terminate his or her own life. (from APA, Thesaurus of Psychological Index Terms, 8th ed).Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created.Shock, Septic: Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include, but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.Withholding Treatment: Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.Acid-Base Imbalance: Disturbances in the ACID-BASE EQUILIBRIUM of the body.Palliative Care: Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)Time Factors: Elements of limited time intervals, contributing to particular results or situations.Respiratory Insufficiency: Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Interlibrary LoansHypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Disease Outbreaks: Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.Acute Disease: Disease having a short and relatively severe course.Infant, Newborn: An infant during the first month after birth.Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously).Candidiasis, Invasive: An important nosocomial fungal infection with species of the genus CANDIDA, most frequently CANDIDA ALBICANS. Invasive candidiasis occurs when candidiasis goes beyond a superficial infection and manifests as CANDIDEMIA, deep tissue infection, or disseminated disease with deep organ involvement.Transportation of Patients: Conveying ill or injured individuals from one place to another.Ventilator Weaning: Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Patient Transfer: Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.Oliguria: Decreased URINE output that is below the normal range. Oliguria can be defined as urine output of less than or equal to 0.5 or 1 ml/kg/hr depending on the age.Respiratory Distress Syndrome, Adult: A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.United StatesHyperglycemia: Abnormally high BLOOD GLUCOSE level.Pneumonia, Ventilator-Associated: Serious INFLAMMATION of the LUNG in patients who required the use of PULMONARY VENTILATOR. It is usually caused by cross bacterial infections in hospitals (NOSOCOMIAL INFECTIONS).Dangerous Behavior: Actions which have a high risk of being harmful or injurious to oneself or others.Point-of-Care Systems: Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Professional-Family Relations: The interactions between the professional person and the family.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Hypoalbuminemia: A condition in which albumin level in blood (SERUM ALBUMIN) is below the normal range. Hypoalbuminemia may be due to decreased hepatic albumin synthesis, increased albumin catabolism, altered albumin distribution, or albumin loss through the urine (ALBUMINURIA).Cross Infection: Any infection which a patient contracts in a health-care institution.Patient Admission: The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.Insanity Defense: A legal concept that an accused is not criminally responsible if, at the time of committing the act, the person was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act done or if the act was known, to not have known that what was done was wrong. (From Black's Law Dictionary, 6th ed)Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Hospitalization: The confinement of a patient in a hospital.Hypoglycemia: A syndrome of abnormally low BLOOD GLUCOSE level. Clinical hypoglycemia has diverse etiologies. Severe hypoglycemia eventually lead to glucose deprivation of the CENTRAL NERVOUS SYSTEM resulting in HUNGER; SWEATING; PARESTHESIA; impaired mental function; SEIZURES; COMA; and even DEATH.Double Effect Principle: Guideline for determining when it is morally permissible to perform an action to pursue a good end with knowledge that the action will also bring about bad results. It generally states that, in cases where a contemplated action has such double effect, the action is permissible only if: it is not wrong in itself; the bad result is not intended; the good result is not a direct causal result of the bad result; and the good result is "proportionate to" the bad result. (from Solomon, "Double Effect," in Becker, The Encyclopedia of Ethics, 1992)Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Medical Futility: The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (From Ann Intern Med 1990 Jun 15;112(12):949)Parenteral Nutrition, Total: The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins.Catheterization, Swan-Ganz: Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Hospices: Facilities or services which are especially devoted to providing palliative and supportive care to the patient with a terminal illness and to the patient's family.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Surgical Procedures, Operative: Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Erythrocyte Transfusion: The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor.Euthanasia, Active: The act or practice of killing for reasons of mercy, i.e., in order to release a person or animal from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed)Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Adrenal Insufficiency: Conditions in which the production of adrenal CORTICOSTEROIDS falls below the requirement of the body. Adrenal insufficiency can be caused by defects in the ADRENAL GLANDS, the PITUITARY GLAND, or the HYPOTHALAMUS.Organ Dysfunction Scores: Ratings that express, in numerical values, the degree of impairment or abnormality in the function of specific organs.Intubation, Gastrointestinal: The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc.Euthyroid Sick Syndromes: Conditions of abnormal THYROID HORMONES release in patients with apparently normal THYROID GLAND during severe systemic illness, physical TRAUMA, and psychiatric disturbances. It can be caused by the loss of endogenous hypothalamic input or by exogenous drug effects. The most common abnormality results in low T3 THYROID HORMONE with progressive decrease in THYROXINE; (T4) and TSH. Elevated T4 with normal T3 may be seen in diseases in which THYROXINE-BINDING GLOBULIN synthesis and release are increased.Family: A social group consisting of parents or parent substitutes and children.Fever: An abnormal elevation of body temperature, usually as a result of a pathologic process.Calcitonin: A peptide hormone that lowers calcium concentration in the blood. In humans, it is released by thyroid cells and acts to decrease the formation and absorptive activity of osteoclasts. Its role in regulating plasma calcium is much greater in children and in certain diseases than in normal adults.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Great BritainGastroenteritis: INFLAMMATION of any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Causes of gastroenteritis are many including genetic, infection, HYPERSENSITIVITY, drug effects, and CANCER.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Travel: Aspects of health and disease related to travel.Blood Volume Determination: Method for determining the circulating blood volume by introducing a known quantity of foreign substance into the blood and determining its concentration some minutes later when thorough mixing has occurred. From these two values the blood volume can be calculated by dividing the quantity of injected material by its concentration in the blood at the time of uniform mixing. Generally expressed as cubic centimeters or liters per kilogram of body weight.Forensic Psychiatry: Psychiatry in its legal aspects. This includes criminology, penology, commitment of mentally ill, the psychiatrist's role in compensation cases, the problems of releasing information to the court, and of expert testimony.Persian Gulf Syndrome: Unexplained symptoms reported by veterans of the Persian Gulf War with Iraq in 1991. The symptoms reported include fatigue, skin rash, muscle and joint pain, headaches, loss of memory, shortness of breath, gastrointestinal and respiratory symptoms, and extreme sensitivity to commonly occurring chemicals. (Nature 1994 May 5;369(6475):8)Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Advance Directives: Declarations by patients, made in advance of a situation in which they may be incompetent to decide about their own care, stating their treatment preferences or authorizing a third party to make decisions for them. (Bioethics Thesaurus)Blood Glucose: Glucose in blood.Caregivers: Persons who provide care to those who need supervision or assistance in illness or disability. They may provide the care in the home, in a hospital, or in an institution. Although caregivers include trained medical, nursing, and other health personnel, the concept also refers to parents, spouses, or other family members, friends, members of the clergy, teachers, social workers, fellow patients.Materials Management, Hospital: The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.Influenza, Human: An acute viral infection in humans involving the respiratory tract. It is marked by inflammation of the NASAL MUCOSA; the PHARYNX; and conjunctiva, and by headache and severe, often generalized, myalgia.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Resuscitation: The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Homeless Persons: Persons who have no permanent residence. The concept excludes nomadic peoples.Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney.Euthanasia, Active, Voluntary: Active euthanasia of a patient at the patient's request and/or with the patient's consent.Air Ambulances: Fixed-wing aircraft or helicopters equipped for air transport of patients.Child, Hospitalized: Child hospitalized for short term care.Social Distance: The degree of closeness or acceptance an individual or group feels toward another individual or group.Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Hospice Care: Specialized health care, supportive in nature, provided to a dying person. A holistic approach is often taken, providing patients and their families with legal, financial, emotional, or spiritual counseling in addition to meeting patients' immediate physical needs. Care may be provided in the home, in the hospital, in specialized facilities (HOSPICES), or in specially designated areas of long-term care facilities. The concept also includes bereavement care for the family. (From Dictionary of Health Services Management, 2d ed)Pneumonia: Infection of the lung often accompanied by inflammation.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Resuscitation Orders: Instructions issued by a physician pertaining to the institution, continuation, or withdrawal of life support measures. The concept includes policies, laws, statutes, decisions, guidelines, and discussions that may affect the issuance of such orders.Encephalitis Viruses, Tick-Borne: A subgroup of the genus FLAVIVIRUS that causes encephalitis and hemorrhagic fevers and is found in eastern and western Europe and the former Soviet Union. It is transmitted by TICKS and there is an associated milk-borne transmission from viremic cattle, goats, and sheep.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Thermodilution: Measurement of blood flow based on induction at one point of the circulation of a known change in the intravascular heat content of flowing blood and detection of the resultant change in temperature at a point downstream.Home Care Services: Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Clinical Protocols: Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy.Pediatric Nursing: The nursing specialty concerning care of children from birth to adolescence. It includes the clinical and psychological aspects of nursing care.Nurse-Patient Relations: Interaction between the patient and nurse.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Gram-Negative Bacterial Infections: Infections caused by bacteria that show up as pink (negative) when treated by the gram-staining method.Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Lipocalins: A diverse family of extracellular proteins that bind to small hydrophobic molecules. They were originally characterized as transport proteins, however they may have additional roles such as taking part in the formation of macromolecular complexes with other proteins and binding to CELL SURFACE RECEPTORS.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Baths: The immersion or washing of the body or any of its parts in water or other medium for cleansing or medical treatment. It includes bathing for personal hygiene as well as for medical purposes with the addition of therapeutic agents, such as alkalines, antiseptics, oil, etc.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Deep Sedation: Drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposely following repeated painful stimulation. The ability to independently maintain ventilatory function may be impaired. (From: American Society of Anesthesiologists Practice Guidelines)Ambulances: A vehicle equipped for transporting patients in need of emergency care.Venous Thromboembolism: Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream.Anuria: Absence of urine formation. It is usually associated with complete bilateral ureteral (URETER) obstruction, complete lower urinary tract obstruction, or unilateral ureteral obstruction when a solitary kidney is present.Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process.Ethics, Medical: The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Anticoagulants: Agents that prevent clotting.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Observation: The act of regarding attentively and studying facts and occurrences, gathering data through analyzing, measuring, and drawing conclusions, with the purpose of applying the observed information to theoretical assumptions. Observation as a scientific method in the acquisition of knowledge began in classical antiquity; in modern science and medicine its greatest application is facilitated by modern technology. Observation is one of the components of the research process.Stress, Psychological: Stress wherein emotional factors predominate.Bacterial Infections: Infections by bacteria, general or unspecified.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.GermanyPsychomotor Agitation: A feeling of restlessness associated with increased motor activity. This may occur as a manifestation of nervous system drug toxicity or other conditions.Abdominal Cavity: The region in the abdomen extending from the thoracic DIAPHRAGM to the plane of the superior pelvic aperture (pelvic inlet). The abdominal cavity contains the PERITONEUM and abdominal VISCERA, as well as the extraperitoneal space which includes the RETROPERITONEAL SPACE.Decontamination: The removal of contaminating material, such as radioactive materials, biological materials, or CHEMICAL WARFARE AGENTS, from a person or object.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Influenza A Virus, H1N1 Subtype: A subtype of INFLUENZA A VIRUS with the surface proteins hemagglutinin 1 and neuraminidase 1. The H1N1 subtype was responsible for the Spanish flu pandemic of 1918.Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Cardiac Output: The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).EnglandBurns: Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like.Muscle Weakness: A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases. (From Wyngaarden et al., Cecil Textbook of Medicine, 19th ed, p2251)Neonatology: A subspecialty of Pediatrics concerned with the newborn infant.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.CreatinineCommunication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Third-Party Consent: Informed consent given by someone other than the patient or research subject.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Colistin: Cyclic polypeptide antibiotic from Bacillus colistinus. It is composed of Polymyxins E1 and E2 (or Colistins A, B, and C) which act as detergents on cell membranes. Colistin is less toxic than Polymyxin B, but otherwise similar; the methanesulfonate is used orally.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Colloids: Two-phase systems in which one is uniformly dispersed in another as particles small enough so they cannot be filtered or will not settle out. The dispersing or continuous phase or medium envelops the particles of the discontinuous phase. All three states of matter can form colloids among each other.Homebound Persons: Those unable to leave home without exceptional effort and support; patients (in this condition) who are provided with or are eligible for home health services, including medical treatment and personal care. Persons are considered homebound even if they may be infrequently and briefly absent from home if these absences do not indicate an ability to receive health care in a professional's office or health care facility. (From Facts on File Dictionary of Health Care Management, 1988, p309)Freedom: The rights of individuals to act and make decisions without external constraints.Skin Care: Maintenance of the hygienic state of the skin under optimal conditions of cleanliness and comfort. Effective in skin care are proper washing, bathing, cleansing, and the use of soaps, detergents, oils, etc. In various disease states, therapeutic and protective solutions and ointments are useful. The care of the skin is particularly important in various occupations, in exposure to sunlight, in neonates, and in PRESSURE ULCER.Statistics, Nonparametric: A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Ventilators, Mechanical: Mechanical devices used to produce or assist pulmonary ventilation.Calorimetry, Indirect: Calculation of the energy expenditure in the form of heat production of the whole body or individual organs based on respiratory gas exchange.ROC Curve: A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.Health Status Indicators: The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues.Patients: Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Death: Irreversible cessation of all bodily functions, manifested by absence of spontaneous breathing and total loss of cardiovascular and cerebral functions.Infection: Invasion of the host organism by microorganisms that can cause pathological conditions or diseases.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Diarrhea: An increased liquidity or decreased consistency of FECES, such as running stool. Fecal consistency is related to the ratio of water-holding capacity of insoluble solids to total water, rather than the amount of water present. Diarrhea is not hyperdefecation or increased fecal weight.Schizophrenia: A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior.Physician-Patient Relations: The interactions between physician and patient.Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, IMIPENEM, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukotriene E4.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Caliciviridae Infections: Virus diseases caused by CALICIVIRIDAE. They include HEPATITIS E; VESICULAR EXANTHEMA OF SWINE; acute respiratory infections in felines, rabbit hemorrhagic disease, and some cases of gastroenteritis in humans.
Pastoral Help For the Entire Family During Terminal IllnessA family needs to come together, openly communicate and help each other when one member becomes terminally ill ... Pastoral Care must go beyond merely the terminally patient but to the entire family ...
More Hospital Deaths and Invasive Care for Dying Cancer Patients Receiving Chemotherapy: StudyThe scientists analyzed data from 386 patients in the federally funded Coping with Cancer study, which followed terminally ill ... or to acknowledge they were terminally ill, she noted. With 56 percent of patients receiving palliative chemotherapy in their ...
terminally ill patients - Thaindian Newsterminally ill patients. Freedom at last - thanks to state-backed legal aid. June 29th, 2011 - 12:28 pm ICT by IANS. Chandigarh ... Apex court norms to decide fate of terminally-ill patients. March 7th, 2011 - 11:42 pm ICT by IANS. New Delhi, March 7 (IANS) ... Tihar asked to provide medical care to terminally ill prisoners. February 19th, 2009 - 10:36 pm ICT by IANS. New Delhi, Feb 19 ... Court seeks medical records of terminally ill Tihar inmates. February 16th, 2009 - 10:17 pm ICT by IANS. New Delhi, Feb 16 ( ...
Terminally ill Lockerbie bomber lands in Libya - CNN.comTo those who bear me ill will, the only thing I can say is that I do not return that to you.' ...
Hospice care: Comforting the terminally ill - Mayo ClinicComfort and support for people who are terminally ill. ... What services are offered to a person who is terminally ill? ...
Doctors Put Off End-of-Life Talks With Terminally Ill - ABC NewsDoctors Put Off End-of-Life Talks With Terminally Ill ... Doctors Put Off End-of-Life Talks With Terminally Ill. *. By BY ... 12 (HealthDay News) -- Terminally ill patients have much to consider, from whether they want to die at home or in the hospital ... Hospice is comfort-oriented care, most often offered at home, for those who are terminally ill. ... the survey also raises the issue of doctors offering expensive chemotherapy for terminally ill patients even when there's ...
Terminally ill Bradley Lowery to be England mascot - BBC NewsTerminally ill football fanatic Bradley Lowery will be the England mascot at a World Cup qualifier at Wembley. ... Bradley Lowery: Seriously ill youngster wins Match of the Day goal award ...
Photos of Terminally Ill People Before and After Death - Neatorama... series Life Before Death presents captures of terminally ill individuals at the end of their lives and once again a short time ... Main Blog , Photos of Terminally Ill People Before and After Death Photos of Terminally Ill People Before and After Death ... German photographer Walter Schels' series Life Before Death presents captures of terminally ill individuals at the end of their ...
AN ACT CONCERNING AID IN DYING FOR TERMINALLY ILL PATIENTS.... Be it enacted by the Senate and House of Representatives in ... To enable terminally ill patients to seek an appropriate means of ending their lives. ...
Ellen DeGeneres Surprises Terminally Ill Comedian With HBO Special | ComplexJones, 32, revealed his cancer diagnosis in February and launched a Kickstarter to fund his own hour-long stand-up special.
Family asks governor for release of terminally ill woman | 89.3 KPCCFamily asks governor for release of terminally ill woman. Frank Stoltze. Show caption. Angela Harris speaks to reporters ... The family of a terminally ill Los Angeles woman is pleading with Governor Schwarzenegger to release her from prison so she may ...
Four Men Accused of Selling Stem Cells to Terminally-Ill Patients... Share on facebook Share on twitter Share. *. Email ... The four men had been selling the drugs to terminally ill individuals under the pretense that stem cells had been approved by ... The FBI has said the men gained more than $1.5 million from terminally ill patients. ...
Lay Minister Gives Hope, Compassion To Terminally Ill - tribunedigital-orlandosentinelThe majority of cases handled by the volunteers involve terminally ill patients. When the patient dies, the lay ministers also ... They make home and hospital visits, provide a respite service for those who care for the ill, and offer bereavement counseling ...
Terminally ill Toronto man applies for doctor-assisted death - Toronto - CBC NewsA terminally Toronto man is asking a judge to grant him a physician-assisted death, arguing that he can't wait for the federal ... Terminally ill Toronto man applies for doctor-assisted death. 'I am suffering intolerable pain and distress,' man writes in ... A terminally ill Toronto man is asking a judge to allow him to have a doctor-assisted death. (Chris Kreussling) ... A terminally ill Toronto man is asking a judge to grant him a physician-assisted death. ...
A Giraffe Gives Terminally Ill Zoo Worker A Kiss Goodbye - Video Dailymotion... a terminally ill zoo worker, returned to the Rotterdam, Holland zoo to fulfill his dying wish. He was transported to the zoo by ... Mario, a terminally ill zoo worker, returned to the Rotterdam, Holland zoo to fulfill his dying wish. He was transported to the ... A Giraffe Gives Terminally Ill Zoo Worker A Kiss Goodbye Repost. Like. ...
Philippine Bishops Agree For Use of Marijuana in Terminally IllSenior church leaders in the conservative Philippines agree to support the use of marijuana to ease the pain of the terminally ... ill, they said Monday, but not for recreational reasons. ... We are only referring to terminally-ill patients who are in ... church leaders in the conservative Philippines agree to support the use of marijuana to ease the pain of the terminally ill, ...
Terminally ill Sunderland icon gets special birthday wishes | Sport24Terminally ill youngster Bradley Lowery whose courageous battle with cancer and friendship with Sunderland striker Jermain ... London - Terminally ill youngster Bradley Lowery whose courageous battle with cancer and friendship with Sunderland striker ... Terminally ill Sunderland icon gets special birthday wishes. 2017-05-17 16:01 ...
California to allow terminally ill patients to legally end their lives | Toronto Star... state to allow terminally-ill patients to legally end their lives. ... California to allow terminally ill patients to legally end their lives. Gov. Jerry Brown signed legislation to make California ... Jerry Brown has signed legislation making California the fifth U.S. state to allow terminally-ill patients to legally end their ... SACRAMENTO-California will become the fifth U.S. state to allow terminally-ill patients to legally end their lives using doctor ...
Marketing a New, Complex Financial Option for Terminally Ill - PR NewsWhen Viaticus, Inc. made its debut in 1994 as a subsidiary of CNA Insurance, the initial reaction to its unique financial options for people facing life-th
Pet therapy for terminally ill in Lebanon: Compassionate Care Hospice Opportunity - VolunteerMatchPet therapy for terminally ill in Lebanon'. This is an ongoing opportunity located in Cornwall, Pennsylvania. ... hospice is seeking volunteers willing to offer companionship and friendship while allowing their pet to cheer a terminally ill ...
Terminally ill student's wish is to meet LeBron James | KING5.comTerminally ill student's wish is to meet LeBron James. Stephanie Metzger, WKYC 2:39 PM. PDT May 04, 2017 ...
Son tried to kill his terminally ill mother (From Daily Echo)A MAN has admitted trying to murder his terminally ill mother. ... Son tried to kill his terminally ill mother. Son tried to kill ... A MAN has admitted trying to murder his terminally ill mother. At Winchester Crown Court, Iain Harrison, 50, was given a two- ... where a son admitted carrying out an act that amounted to the attempted murder of his terminally ill mother because he could ... year suspended sentenced for 18 months after pleading guilty to the attempted murder of his terminally ill mother in Dorset. ...
UK rejects terminally ill man's request to be killed - seattlepi.comUK rejects terminally ill man's request to be killed. Updated 5:53 am, Saturday, October 7, 2017 ... Britain's High Court has rejected a terminally ill man's request to be killed with medical help. In a ruling on Thursday, Oct. ... FILE - In this July 19, 2017 file photo, terminally-ill Noel Conway is photographed outside Telford County Court, in Telford, ... FILE - In this July 19, 2017 file photo, terminally-ill Noel Conway is photographed outside Telford County Court, in Telford, ...
Oreo's owner is terminally ill - can you help? | DurhamRegion.comI got this email today and it just about broke my heart. Can you give this cat a forever home?? I am desperately looking for a home for Oreo. He is currently living alone as my Mom is...
Terminally ill Colombian bishop discusses science, faith and hope :: Catholic News Agency (CNA)An editorial published last week by the newspaper La Verdad gave readers a close-up of Colombian Bishop Jaime Prieto Amaya's health. The prelate was diagnosed with terminal cancer in July. The editorial highlighted the bishop's faith and hope amidst his illness, as well as the spiritual solidarity of the faithful. "While it is true that science exists in order to be a truly neutral discipline that seeks only the truth, it is also true that God has always led us to Him through faith and not through logic," the article stated. Therefore, it continued, "A believing people, without ignoring the power and advances of science, is watching with sorrow as their pastor suffers and debates between what science has been able to offer and faith in a God who, beyond the norms of medicine, is capable of giving and prolonging life. Thus do the baptized and the priests of the Diocese of Cucuta believe and profess." After citing a series of biblical examples, the editorial also urged readers to pray that God ...
Apache AvroPrism score of pediatric mortality: The Pediatric Risk of Mortality (PRISM) score was developed from the Physiologic Stability Index (PSI) to reduce the number of physiologic variables required for pediatric intensive-care unit (PICU) mortality risk assessment, from 34 (in the PSI) to 14, and to obtain an objective weighting of the remaining variables.Sepsis Alliance: Sepsis Alliance is a voluntary health organization dedicated to raising awareness of sepsis by educating patients, families, and healthcare professionals to treat sepsis as a medical emergency.http://www.Peak inspiratory pressure: Peak inspiratory pressure (PIP) is the highest level of pressure applied to the lungs during inhalation. In mechanical ventilation the number reflects a positive pressure in centimeters of water pressure (cmH2O).Involuntary commitment: Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a psychiatric hospital (inpatient) or in the community (outpatient).Chao Yao-dong: Chao Yao-dong (died August 20, 2008) was a Taiwanese politician, economist and former Minister of Economic Affairs (1981–84).HemofiltrationRenal replacement therapy: Renal replacement therapy is a term used to encompass life-supporting treatments for renal failure.Non-communicable disease: Non-communicable disease (NCD) is a medical condition or disease that is non-infectious or non-transmissible. NCDs can refer to chronic diseases which last for long periods of time and progress slowly.UNICEF Tap Project: The UNICEF Tap Project is a nationwide campaign that provides children in impoverished nations with access to safe, clean water. The campaign culminates during World Water Week, celebrating the United Nations’ World Water Day, March 22.Dilip Mahalanabis: Dilip Mahalanabis (born November 12, 1934Neurogenic shockEmergence deliriumSystemic inflammatory response syndromeVoluntary euthanasia: Voluntary euthanasia is the practice of ending a life in a painless manner. Voluntary euthanasia (VE) and physician-assisted suicide (PAS) have been the focus of great controversy in recent years.Society for Old Age Rational Suicide: The Society for Old Age Rational Suicide (SOARS) is a group based in the United Kingdom concerned with choice at the end of life. It was established on December 10, 2009 (Human Rights Day) by Dr.Sir Robert Charles Griggs: Sir Robert Charles Griggs (born 1936) is a country and jazz musician living in Hemet, CA.Prognosis: Prognosis (Greek πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely outcome of one's current standing. When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because previous research found that this proportion of patients died.Urine anion gap: The urine anion gap is calculated using measured ions found in the urine. It is used to aid in the differential diagnosis of metabolic acidosis.Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingMental disorderQRISK: QRISK2 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.Student loan default in the United States: Defaulting on a student loan in the United States can have a number of negative consequences. To understand loan default, it is helpful to have a few common terms defined:Nonbenzodiazepine: Nonbenzodiazepines (sometimes referred to colloquially as "Z-drugs") are a class of psychoactive drugs that are very benzodiazepine-like in nature. Nonbenzodiazepines pharmacodynamics are almost entirely the same as benzodiazepine drugs and therefore employ similar benefits, side-effects, and risks.National Outbreak Reporting System: ==The National Outbreak Reporting System (NORS)==Spontaneous breathing trial: A goal for most patients on mechanical ventilation is to be weaned from the ventilator. The weaning process is highly dependent on the patient's pathology, but the final common pathway to ventilator independence always includes at least one trial of spontaneous breathing.OliguriaInfant respiratory distress syndromeList of Parliamentary constituencies in Kent: The ceremonial county of Kent,HyperglycemiaVentilator-associated pneumoniaThe Thrill Killers: The Thrill Killers is a horror/thriller film released in 1964 and directed by low-budget film-maker Ray Dennis Steckler. It stars Cash Flagg (Steckler under a nom de plume) and Liz Renay.Wi, Inc.: Wi, Inc. (pronounced as an initialism, "double-u i.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.BacitracinBiomarkers of aging: Biomarkers of aging are biomarkers that better predict functional capacity at a later age than chronological age. Stated another way, biomarkers of aging would give the true "biological age", which may be different from the chronological age.Infection Control and Hospital Epidemiology: Infection Control and Hospital Epidemiology is a peer-reviewed medical journal published by the University of Chicago Press. It publishes research on control and evaluation of the transmission of pathogens in healthcare institutions and on the use of epidemiological principles and methods to evaluate and improve the delivery of care, including infection control practices, surveillance, cost-benefit analyses, resource use, occupational health, and regulatory issues.InsanityNational Center for Injury Prevention and Control: The U.S.Spontaneous hypoglycemia: The term "spontaneous hypoglycemia" was coined by the physician Seale Harris. (Who stated their source to be Alabama Hall of Fame, 1968)Procedural sedation and analgesia: Procedural sedation and analgesia, previously referred to as conscious sedation, is defined as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function."Parenteral nutrition: Parenteral nutrition (PN) is feeding a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, amino acids, lipids and added vitamins and dietary minerals.Pulmonary artery catheterElizabeth Jenkins (author): Margaret Elizabeth Jenkins (31 October 1905 – 5 September 2010) was an English novelist and biographer of Jane Austen, Henry Fielding, Lady Caroline Lamb, Joseph Lister and Elizabeth I.Revised Cardiac Risk IndexTwo Rivers Psychiatric Hospital: Two Rivers Behavioral Health System is a psychiatric hospital located in Kansas City, Missouri.Groningen Protocol: The Groningen Protocol is a text created in September 2004 by Eduard Verhagen, the medical director of the department of pediatrics at the University Medical Center Groningen (UMCG) in Groningen, the Netherlands. It contains directives with criteria under which physicians can perform "active ending of life on infants" (child euthanasia) without fear of legal prosecution.History of tracheal intubation: Tracheal intubation (usually simply referred to as intubation), an invasive medical procedure, is the placement of a flexible plastic catheter into the trachea. For millennia, tracheotomy was considered the most reliable (and most risky) method of tracheal intubation.Critical illness-related corticosteroid insufficiency: Critical illness-related corticosteroid insufficiency (CIRCI) is a form of adrenal insufficiency in critically ill patients who have blood corticosteroid levels which are inadequate for the severe stress response they experience. Combined with decreased glucocorticoid receptor sensitivity and tissue response to corticosteroids, this adrenal insufficiency constitutes a negative prognostic factor for intensive care patients.Euthyroid sick syndromeRabbit feverProcalcitonin: Procalcitonin (PCT) is a peptide precursor of the hormone calcitonin, the latter being involved with calcium homeostasis. It is composed of 116 amino acids and is produced by parafollicular cells (C cells) of the thyroid and by the neuroendocrine cells of the lung and the intestine.Community mental health service: Community mental health services (CMHS), also known as Community Mental Health Teams (CMHT) in the United Kingdom, support or treat people with mental disorders (mental illness or mental health difficulties) in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Viral gastroenteritis: Viral gastroenteritis (Gastro-Enter-eye,tiss),http://www.merriam-webster.Self-rated health: Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as “in general, would you say that you health is excellent, very good, good, fair, or poor?” and a survey questionnaire in which participants assess different dimensions of their own health.
(1/321) Legalized physician-assisted suicide in Oregon--the first year's experience.
BACKGROUND AND METHODS: On October 27, 1997, Oregon legalized physician-assisted suicide. We collected data on all terminally ill Oregon residents who received prescriptions for lethal medications under the Oregon Death with Dignity Act and who died in 1998. The data were obtained from physicians' reports, death certificates, and interviews with physicians. We compared persons who took lethal medications prescribed under the act with those who died from similar illnesses but did not receive prescriptions for lethal medications. RESULTS: Information on 23 persons who received prescriptions for lethal medications was reported to the Oregon Health Division; 15 died after taking the lethal medications, 6 died from underlying illnesses, and 2 were alive as of January 1, 1999. The median age of the 15 patients who died after taking lethal medications was 69 years; 8 were male, and all 15 were white. Thirteen of the 15 patients had cancer. The case patients and controls were similar with regard to sex, race, urban or rural residence, level of education, health insurance coverage, and hospice enrollment. No case patients or controls expressed concern about the financial impact of their illness. One case patient and 15 controls expressed concern about inadequate control of pain (P=0.10). The case patients were more likely than the controls to have never married (P=0.04) and were more likely to be concerned about loss of autonomy due to illness (P=0.01) and loss of control of bodily functions (P=0.02). At death, 21 percent of the case patients and 84 percent of the controls were completely disabled (P<0.001). CONCLUSIONS: During the first year of legalized physician-assisted suicide in Oregon, the decision to request and use a prescription for lethal medication was associated with concern about loss of autonomy or control of bodily functions, not with fear of intractable pain or concern about financial loss. In addition, we found that the choice of physician-assisted suicide was not associated with level of education or health insurance coverage. (+info)
(2/321) Survival prediction of terminally ill cancer patients by clinical symptoms: development of a simple indicator.
BACKGROUND: Although accurate prediction of survival is essential for palliative care, no clinical tools have been established. METHODS: Performance status and clinical symptoms were prospectively assessed on two independent series of terminally ill cancer patients (training set, n = 150; testing set, n = 95). On the training set, the cases were divided into two groups with or without a risk factor for shorter than 3 and 6 weeks survival, according to the way the classification achieved acceptable predictive value. The validity of this classification for survival prediction was examined on the test samples. RESULTS: The cases with performance status 10 or 20, dyspnea at rest or delirium were classified in the group with a predicted survival of shorter than 3 weeks. The cases with performance status 10 or 20, edema, dyspnea at rest or delirium were classified in the group with a predicted survival of shorter than 6 weeks. On the training set, this classification predicted 3 and 6 weeks survival with sensitivity 75 and 76% and specificity 84 and 78%, respectively. On the test populations, whether patients survived for 3 and 6 weeks or not was predicted with sensitivity 85 and 79% and specificity 84 and 72%, respectively. CONCLUSION: Whether or not patients live for 3 and 6 weeks can be acceptably predicted by this simple classification. (+info)
(3/321) A staff dialogue on aggressive palliative treatment demanded by a terminally ill patient: psychosocial issues faced by patients, their families, and caregivers.
Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. In this article, the case presentation and verbatim dialogue from the rounds are discussed with an emphasis on staff psychosocial issues. The case presented was of a 32-year-old man, who developed small cell osteosarcoma and was treated at MGH. He died after undergoing multiple courses of relatively ineffective chemotherapy. The case is made all the more poignant because of the pleasures, hopes and stresses of having a child late in the course of his illness. Staff identified closely, both with him and his family, and their concern for him brought joy and meaning to their work, yet this complicated their ability to deal with his impending death. They felt that his unwillingness to admit defeat prevented them from saying goodbye to someone whom they loved and admired. Despite this, staff recognized that, ultimately, the patient's emotional needs and wishes had to be respected as a first priority and that constructive closure can be worked toward, if not achieved. In such situations, it is vital to have a colleague support system and a forum for discussion of such issues in order to defuse distress and reassure staff that they are doing all that can be done as professionals and caregivers. (+info)
(4/321) Psychological interventions in general hospitals: background, current status and clinical guidelines.
PURPOSE: To promote the systematic development, interests, practice, research and clinical applications of health psychology in general hospitals in Hong Kong and the mainland of China. DATA SOURCES: The targets and aims of therapeutic work with patients in pain, cancer patients, child and adolescent patients, patients with chronic illnesses, the elderly, and patients requiring organ transplantation are highlighted. STUDY SELECTION: The psychological interventions described are experiences derived from routine clinical services carried out in the Clinical Health Psychology Unit where the authors are affiliated, and can be seen as an example of a more comprehensive psychological intervention program for physically ill patients in Hong Kong. RESULTS: Psychological interventions have intrinsic values in reducing patients' distress and sufferings. The services are also an integral part of modem day comprehensive patient care with positive effects on treatment effectiveness and eventual illness outcome. CONCLUSIONS: Physical illnesses affect a person physically as well as psychologically. Psychological care in general hospitals is cost effective and beneficial in reducing undue psychological complications precipitated by physical afflictions as well as in promoting better overall outcomes. (+info)
(5/321) Chinese and U.S. internists adhere to different ethical standards.
OBJECTIVE: To determine whether internists in the United States and China have different ideas and behaviors regarding informing patients of terminal diagnoses and HIV/AIDS, the role of the family in end-of-life decision making, and assisted suicide. DESIGN: Structured questionnaire of clinical vignettes followed by multiple choice questions. SETTING: University and community hospitals in San Francisco and Beijing, China. SUBJECTS: Forty practicing internists were interviewed, 20 in China and 20 in the United States. MEASUREMENTS AND MAIN RESULTS: Of the internists surveyed, 95% of the U.S. internists and none of the Chinese internists would inform a patient with cancer of her diagnosis. However, 100% of U.S. and 90% of Chinese internists would tell a terminally ill patient who had AIDS, rather than advanced cancer, about his diagnosis. When family members' wishes conflicted with a patient's preferences regarding chemotherapy of advanced cancer, Chinese internists were more likely to follow the family's preferences rather than the patient's preferences (65%) than were the U.S. internists (5%). Thirty percent of U.S. internists and 15% of Chinese internists agreed with a terminally ill patient's request for sufficient narcotics to end her life. CONCLUSIONS: We found significant differences in clinical ethical beliefs between internists in the United States and China, most evident in informing patients of a cancer diagnosis. In general, the Chinese physicians appeared to give far greater weight to family preferences in medical decision making than did the U.S. physicians. (+info)
(6/321) Assistance from family members, friends, paid care givers, and volunteers in the care of terminally ill patients.
BACKGROUND: In addition to medical care, dying patients often need many types of assistance, including help with transportation, nursing care, homemaking services, and personal care. We interviewed terminally ill adults and their care givers in six randomly selected areas of the United States (five metropolitan areas and one rural county) to determine how their needs for assistance were met and the frequency with which they received such assistance from family members and paid and volunteer care givers. METHODS: The patients, whose physicians estimated them to have less than six months to live and who had clinically significant illness other than human immunodeficiency virus infection or the acquired immunodeficiency syndrome, were referred to the study by their physicians. Of the 1131 eligible patients, 988 (87.4 percent) consented to a detailed in-person interview conducted in English, as did 893 of the 915 eligible primary care givers (97.6 percent). RESULTS: Of the 988 terminally ill patients, 59.4 percent were over the age of 65 years, and 51.5 percent were women. The most frequent terminal illness was cancer (in 51.8 percent of the patients), followed by heart disease (18.0 percent) and chronic obstructive pulmonary disease (10.9 percent). Four percent of the patients were in an institution, such as a nursing home, residential hospice, or hospital; the rest were living in a private residence. A need for assistance was reported by 86.8 percent of the patients; they required help with transportation (reported by 62.0 percent), homemaking services (55.2 percent), nursing care (28.7 percent), and personal care (26.0 percent). Of the care givers, 72.1 percent were women. Primary care givers were family members in 96.0 percent of cases; only 4.0 percent were unrelated. Most patients relied completely on family members and friends for assistance. A total of 15.5 percent of patients relied only on paid assistance for more than half of the types of care that they needed. Volunteers (that is, unpaid helpers who were not family members or friends) provided less than 3 percent of all care. CONCLUSIONS: In our survey of terminally ill patients, family members, usually women, provided the majority of assistance with nonmedical care. Although many people received assistance from paid care givers, very few had assistance from volunteers. (+info)
(7/321) Response of paramedics to terminally ill patients with cardiac arrest: an ethical dilemma.
BACKGROUND: In an environment characterized by cuts to health care, hospital closures, increasing reliance on home care and an aging population, more terminally ill patients are choosing to die at home. The authors sought to determine the care received by these patients when paramedics were summoned by a 911 call and to document whether do-not-resuscitate (DNR) requests influenced the care given. METHODS: The records of a large urban emergency medical services system were reviewed to identify consecutive patients with cardiac arrest over the 10-month period November 1996 to August 1997. Data were abstracted from paramedics' ambulance call reports according to a standardized template. The proportion of these patients described as having a terminal illness was determined, as was the proportion of terminally ill patients with a DNR request. The resuscitative efforts of paramedics were compared for patients with and without a DNR request. RESULTS: Of the 1534 cardiac arrests, 144 (9.4%) involved patients described as having a terminal illness. The mean age of the patients was 72.2 (standard deviation 14.8) years. Paramedics encountered a DNR request in 90 (62.5%) of these cases. Current regulations governing paramedic practice were not followed in 34 (23.6%) of the cases. There was no difference in the likelihood that cardiopulmonary resuscitation (CPR) would be initiated between patients with and those without a DNR request (73% v. 83%; p = 0.17). In patients for whom CPR was initiated, paramedics were much more likely to withhold full advanced cardiac life support if there was a DNR request than if there was not (22% v. 68%; p < 0.001). INTERPRETATION: Paramedics are frequently called to attend terminally ill patients with cardiac arrest. Current regulations are a source of conflict between the paramedic's duty to treat and the patient's right to limit resuscitative efforts at the time of death. (+info)
(8/321) A randomized controlled trial of local injections of hyaluronidase versus placebo in cancer patients receiving subcutaneous hydration.
BACKGROUND: Most cancer patients develop reduced oral intake or dehydration before death. Subcutaneous hydration (SCH) can be safe and effective. SCH is frequently administered using hyaluronidase to improve fluid absorption. The objective of this study was to determine the effects of hyaluronidase on patient comfort during bolus SCH. PATIENTS AND METHODS: Twenty-one cancer patients requiring parenteral hydration were administered a 500 cc bolus of two-thirds dextrose (5%) and one-third normal saline solution subcutaneously at 08:00 and 16:00 hours during day 1 and day 2. On day 1 patients were randomized on a double-blind basis to receive 150 units of hyaluronidase versus placebo as a bolus into the site of infusion immediately before starting each one-hour infusion. During day 2 patients were crossed over to receive the alternate treatment at a new infusion site. Visual analogue scales (0 = best, 100 = worst) for pain and swelling at the infusion site were completed by each patient. In addition, investigators blindly assessed the site of infusion for the presence of edema, rash, and leakage. RESULTS: No significant differences were observed for pain, swelling, edema, rash or leakage between the placebo and the hyaluronidase scores. After completion of the two days of the study, patients blindly chose hyaluronidase in 1 (5%) case, placebo in 5 (24%) cases, and no preference in 15 (71%) cases (P < 0.01). There was no treatment or interaction effect for pain, except for a period effect (P = 0.045) for the morning bolus administration. There were no treatment, period, or interaction effects for any of the other variables. CONCLUSIONS: Our results suggest that hyaluronidase is not necessary for routine bolus SCH. It may still be useful for a minority of patients who are not able to tolerate infusion well due to swelling or pain. (+info)
- Terminally ill football fanatic Bradley Lowery will be the England mascot at a World Cup qualifier at Wembley. (bbc.com)
- London - Terminally ill youngster Bradley Lowery whose courageous battle with cancer and friendship with Sunderland striker Jermain Defoe has made him one of the iconic faces of the football season spent his sixth birthday in hospital on Wednesday. (sport24.co.za)
- New Delhi, March 7 (IANS) The Supreme Court Monday laid down the guidelines on withdrawal of life support systems of terminally-ill patients. (thaindian.com)
- New Delhi, Feb 16 (IANS) Concerned over the plight of terminally ill patients lodged in Tihar jail, the Delhi High Court Monday sought medical records of 16 such patients. (thaindian.com)
- TUESDAY, Jan. 12 (HealthDay News) -- Terminally ill patients have much to consider, from whether they want to die at home or in the hospital to whether they want doctors to continue aggressive treatment or focus on making them comfortable during their final weeks or months. (go.com)
- As the nation grapples with reining in health care costs, the survey also raises the issue of doctors offering expensive chemotherapy for terminally ill patients even when there's little chance it will work, Keating said. (go.com)
- To enable terminally ill patients to seek an appropriate means of ending their lives. (ct.gov)
- The FBI has said the men gained more than $1.5 million from terminally ill patients. (christianpost.com)
- The majority of cases handled by the volunteers involve terminally ill patients. (orlandosentinel.com)
- We are only referring to terminally-ill patients who are in severe pain," he told a press conference called to announce the Pope's visit to the country next January. (medindia.net)
- Gov. Jerry Brown signed legislation to make California fifth U.S. state to allow terminally-ill patients to legally end their lives. (thestar.com)
- SACRAMENTO-California will become the fifth U.S. state to allow terminally-ill patients to legally end their lives using doctor-prescribed drugs after Gov. Jerry Brown announced Monday he had signed the legislation. (thestar.com)
- Religious groups and advocates for people with disabilities opposed the bill and nearly identical legislation that had stalled in the Legislature weeks earlier, saying it goes against the will of God and puts terminally ill patients at risk for coerced death. (thestar.com)
- German photographer Walter Schels ' series Life Before Death presents captures of terminally ill individuals at the end of their lives and once again a short time after their deaths. (neatorama.com)
- A terminally ill Toronto man is asking a judge to allow him to have a doctor-assisted death. (cbc.ca)
- The four men had been selling the drugs to terminally ill individuals under the pretense that stem cells had been approved by the FDA to treat their fatal diseases. (christianpost.com)
- Compassionate Care hospice is seeking volunteers willing to offer companionship and friendship while allowing their pet to cheer a terminally ill patient. (volunteermatch.org)
- Opponents said the bill legalizes premature suicide, but supporters call that comparison inappropriate because it applies to mentally sound, terminally ill people and not those who are depressed or impaired. (thestar.com)
- Senior church leaders in the conservative Philippines agree to support the use of marijuana to ease the pain of the terminally ill, they said Monday, but not for recreational reasons. (medindia.net)
- Hospice is comfort-oriented care, most often offered at home, for those who are terminally ill. (go.com)
- Among them are doctors, interior designers and homemakers who administer Holy Communion to those who cannot attend Mass. They make home and hospital visits, provide a respite service for those who care for the ill, and offer bereavement counseling to those having difficulty accepting the loss of loved ones. (orlandosentinel.com)