Wow! A day and a half to get home. Who knew there would be snow in Minnesota in the winter? I hope you find yourself as reinvigorated by the Assembly as I have been.
So what were the other key articles? Well, perhaps you’ve seen Lyle Fettig’s excellent post at PalliMed complete with hyperlinks. If not, here’s Part II:
What is the experience that children undergo when treated with Stem cell transplant (SCT) for malignancy? Parents and Physician’s perspectives are presented in Ullrich CK, Dussel V, Hilden JM, Sheaffer JW, Lehmann L, Wolfe J Blood 2010 115: 3879-85. While success rates are improving, 5-year survival for children undergoing SCT is 50-60%. Physicians and parents of children who underwent SCT as the last mode of cancer-directed therapy reported knowing that the treatment will not result in cure less often and later than those of children who do not undergo SCT. This was associated with more use of life-sustaining treatments, less planning, and increased symptom burden for the children.
And for those with Dementia, the impact of pneumonia is described in Givens JL, Jones RN, Shaffer ML, Kiely DK, Mitchell SL Archives of Internal Medicine 2010 170: 1102-7. This study can be used to help surrogates decide whether or not to initiate antibiotics in severely demented patients in LTC. Residents in 22 Boston area nursing homes were studied.
The first study presents a randomized trial of disease specific discussions from the Respecting Choices program of LaCrosse Wi. Patients and their surrogates were randomized to either a facilitated interview or usual care. For patients with CHF or ESRD, a facilitated, structured patient-surrogate interview improved surrogate understanding of patient preferences for care at the end of life.