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David's Collection

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By David Henry, MD 75 YO ,Family Medicine, Geriatric MD. Shreveport , LA Office,long term care, hospice consultant, medical consultant two psych units, med director for LTC
Haley Gittleman, Daniel Lim, Michael W Kattan, Arnab Chakravarti, Mark R Gilbert, Andrew B Lassman, Simon S Lo, Mitchell Machtay, Andrew E Sloan, Erik P Sulman, Devin Tian, Michael A Vogelbaum, Tony J C Wang, Marta Penas-Prado, Emad Youssef, Deborah T Blumenthal, Peixin Zhang, Minesh P Mehta, Jill S Barnholtz-Sloan
BACKGROUND: Glioblastoma (GBM) is the most common primary malignant brain tumor. Nomograms are often used for individualized estimation of prognosis. This study aimed to build and independently validate a nomogram to estimate individualized survival probabilities for patients with newly diagnosed GBM, using data from 2 independent NRG Oncology Radiation Therapy Oncology Group (RTOG) clinical trials. METHODS: This analysis included information on 799 (RTOG 0525) and 555 (RTOG 0825) eligible and randomized patients with newly diagnosed GBM and contained the following variables: age at diagnosis, race, gender, Karnofsky performance status (KPS), extent of resection, O(6)-methylguanine-DNA methyltransferase (MGMT) methylation status, and survival (in months)...
September 23, 2016: Neuro-oncology
Melissa M Garrido, Holly G Prigerson, Joan D Penrod, Shatice C Jones, Kenneth S Boockvar
PURPOSE: The 2014 American Geriatrics Society's Choosing Wisely list cautions against the use of any benzodiazepines or other sedative-hypnotics (BSHs) as initial treatments for agitation, insomnia, or delirium in older adults. Because these symptoms are prevalent among hospitalized patients, seriously ill older adults are at risk of receiving these potentially inappropriate medications. The objectives of this study were to understand the extent to which potentially inappropriate BSHs are being used in hospitalized, seriously ill, older veterans and to understand what clinical and sociodemographic characteristics are associated with potentially inappropriate BSH use...
November 1, 2014: Clinical Therapeutics
John Phillips, David Wendler
A primary goal of clinical practice is to respect patient autonomy. To promote this goal for patients who have lost the ability to make their own decisions, commentators recommend that surrogates make their treatment decisions based on the substituted judgment standard. This standard is commonly interpreted as directing surrogates to make the decision the patient would have made in the circumstances, if the patient were competent. However, recent commentators have argued that this approach--attempting to make the decision the patient would have made if competent--is theoretically problematic, practically infeasible, and ignores the interests of the patient's family and loved ones...
September 2015: Journal of Medical Ethics
Richard J Caselli, Jessica Langbaum, Gary E Marchant, Rachel A Lindor, Katherine S Hunt, Bruce R Henslin, Amylou C Dueck, Jason S Robert
OBJECTIVE: To explore the self-expressed desire for, envisioned reaction to, and basic understanding of presymptomatic Alzheimer disease (AD)-related genetic and biomarker tests. PATIENTS AND METHODS: The Alzheimer's Prevention Registry is an online community of people at least 18 years of age who are interested in AD prevention research for purely informational purposes or to be considered for possible research participation in future studies. Information about presymptomatic testing and an online multiple choice format survey were posted from November 1, 2012, through June 20, 2013, on the registry website...
October 2014: Mayo Clinic Proceedings
Brendan M Reilly
What she wants seems reasonable enough, a request I've heard from patients before. During my 40 years as a clinician-educator at academic medical centers, I've come to rely on a redoubtable reply: That's not the way we do things here. This is a teaching hospital. If you don't want residents or..
July 24, 2014: New England Journal of Medicine
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