Letter: pain in terminal disease

JAMA ◽  
1975 ◽  
Vol 232 (11) ◽  
pp. 1127c-1127
Author(s):  
S. A. Lack
Keyword(s):  
Terminal Disease

Integrin α6 (CD49f), The Microenvironment and Cancer Stem Cells

2019 ◽  
Vol 14 (5) ◽  
pp. 428-436 ◽  
Author(s):  
Gabriele D. Bigoni-Ordóñez ◽  
Daniel Czarnowski ◽  
Tyler Parsons ◽  
Gerard J. Madlambayan ◽  
Luis G. Villa-Diaz
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Cancer Stem Cells ◽  
Cancer Stem Cell ◽  
The Self ◽  
Self Renewal ◽  
Terminal Disease

Cancer is a highly prevalent and potentially terminal disease that affects millions of individuals worldwide. Here, we review the literature exploring the intricacies of stem cells bearing tumorigenic characteristics and collect evidence demonstrating the importance of integrin α6 (ITGA6, also known as CD49f) in cancer stem cell (CSC) activity. ITGA6 is commonly used to identify CSC populations in various tissues and plays an important role sustaining the self-renewal of CSCs by interconnecting them with the tumorigenic microenvironment.

No Longer Disabled: The Legal Impact of the New Social Construction of HIV

1997 ◽  
Vol 23 (1) ◽  
pp. 7-43
Author(s):  
Wendy E. Parmet ◽  
Daniel J. Jackson
Keyword(s):  
Chronic Disease ◽  
Social Construction ◽  
Social Problem ◽  
Positive Development ◽  
Hiv Disease ◽  
Term Survival ◽  
Medical Interventions ◽  
Terminal Disease ◽  
Hiv Epidemic

The second social construction of HIV disease has begun. In the first fifteen years of the HIV epidemic, many viewed the disease “as the modern plague.” Now, as the epidemic matures and new “miracle treatments" are heralded, the disease is beginning to conjure a very different set of images. Where once AIDS was dreaded as the inexplicable cataclysm of the end of the millennium, now, as the virus appears amenable to treatment, we are beginning to see the disease as something both preventable and controllable, no longer beyond human direction. And, where the disease was once synonymous with death, disability, and decline, we now witness stories of miracle recoveries and long-term survival. In the minds of many, the terminal disease has become the chronic disease; the dreaded plague has become but another social problem.In most respects, the new social construction of HIV, emerging from the advent of potentially effective medical interventions, is a positive development.

The Experience of the Puerto Rican Family When a Member Has HIV/AIDS

2003 ◽  
Vol 84 (3) ◽  
pp. 377-384 ◽  
Author(s):  
Ida Roldán
Keyword(s):  
Qualitative Study ◽  
Puerto Rican ◽  
Primary Objective ◽  
Terminal Disease ◽  
Department Of Health ◽  
Research Article ◽  
Puerto Rican Culture ◽  
Puerto Rican Families ◽  
Hiv Aids

As of June 2001, it was estimated that 22,000 people were living with AIDS in Chicago (CDC, 2001b), and 15% of these were Hispanic, of which 39% were Puerto Rican (Chicago Department of Health, 2000b). Although in recent years Chicago has seen a drop in HIV/AIDS-related deaths, HIV/AIDS is still devastating many Puerto Rican families. Many of those infected face the challenges of living with a chronic terminal disease, feeling alone and rejected by family and community. This research article summarizes the results of a qualitative study that explores the unique meanings that the Puerto Rican culture assigns to AIDS. The primary objective of this study was to capture the experience that is unique to the Puerto Rican family when a member has HIV/AIDS.

Relational and therapeutic aspects of children with late onset of a terminal disease

1993 ◽  
Vol 9 (6) ◽  
pp. 339-342 ◽  
Author(s):  
G. Lanzi ◽  
U. Balottin ◽  
R. Borgatti ◽  
A. Ottolini
Keyword(s):  
Late Onset ◽  
Terminal Disease

Prevalence and characteristics of breakthrough pain in patients with non-malignant terminal disease admitted to a hospice

2001 ◽  
Vol 15 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Giovambattista Zeppetella ◽  
Catherine A O'Doherty ◽  
Silke Collins
Keyword(s):  
Breakthrough Pain ◽  
Terminal Disease

Paramedic Knowledge, Attitudes, and Training in End-of-Life Care

2009 ◽  
Vol 24 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Susan C. Stone ◽  
Jean Abbott ◽  
Christian D. McClung ◽  
Chris B. Colwell ◽  
Marc Eckstein ◽  
...  
Keyword(s):  
Los Angeles ◽  
End Of Life ◽  
Life Support ◽  
Clinical Skills ◽  
Chi Square ◽  
Convenience Sample ◽  
Terminal Disease ◽  
The Past ◽  
Almost All ◽  
Eol Care

AbstractIntroduction:Paramedics often are asked to care for patients at the end of life. To do this, they must communicate effectively with family and caregivers, understand their legal obligations, and know when to withhold unwanted interventions. The objectives of this study were to ascertain paramedics' attitudes toward end-of-life (EOL) situations and the frequency with which they encounter them; and to compare paramedics' preparation during training for a variety of EOL care skills.Methods:A written survey was administered to a convenience sample of paramedics in two cities: Denver, Colorado and Los Angeles, California. Questions addressed: (1) attitudes toward EOL decision-making in prehospital settings; (2) experience (number of EOL situations experienced in the past two years); (3) importance of various EOL tasks in clinical practice (pronouncing and communicating death, ending resuscitation, honoring advance directives (ADs)); and (4) self-assessed preparation for these EOL tasks. For each task, importance and preparation were measured using a four-point Likert scale. Proportions were compared using McNemar chi-square statistics to identify areas of under or over-preparation.Results:Two hundred thirty-six paramedics completed the survey. The mean age was 39 years (range 22–59 years), and 222 (94%) were male. Twenty percent had >20 years of experience. Almost all participants (95%; 95% CI = 91–97%) agreed that prehospital providers should honor field ADs, and more than half (59%; 95% CI = 52–65%) felt that providers should honor verbal wishes to limit resuscitation at the scene. Ninety-eight percent of the participants (95% CI = 96–100%) had questioned whether specific life support interventions were appropriate for patients who appeared to have a terminal disease. Twenty-six percent (95% CI = 20–32%) reported to have used their own judgment during the past two years to withhold or end resuscitation in a patient who appeared to have a terminal disease. Significant discrepancies between the importance in practice and the level of preparation during training for the four EOL situations included: (1) understanding ADs (75% very important vs. 40% well prepared; difference 35%: 95% CI = 26–43%); (2) knowing when to honor written ADs (90% very important vs. 59% well-prepared; difference 31%: 95% CI = 23–38%); and (3) verbal ADs (75% very important vs. 54% well-prepared, difference 21%: 95% CI = 12–29%); and (4) communicating death to family or friends (79% very important vs. 48% well prepared, difference 31%: 95% CI = 23–39%). Paramedics' preparation in EOL skills was significantly lower than that for clinical skills such as endotracheal intubation or defibrillation.Conclusions:There is a need to include more training in EOL care into prehospital training curricula, including how to verify and apply ADs, when to withhold treatments, and how to discuss death with victims' family or friends.

scholarly journals Chronic Subclinical Prion Disease Induced by Low-Dose Inoculum

2002 ◽  
Vol 76 (5) ◽  
pp. 2510-2517 ◽  
Author(s):  
Alana M. Thackray ◽  
Michael A. Klein ◽  
Adriano Aguzzi ◽  
Raymond Bujdoso
Keyword(s):  
Brain Tissue ◽  
Prion Disease ◽  
Low Dose ◽  
Clinical Signs ◽  
Rocky Mountain ◽  
Rapid Onset ◽  
Distinct Pattern ◽  
High Dose ◽  
Terminal Disease ◽  
Subclinical Disease

ABSTRACT We have compared the transmission characteristics of the two mouse-adapted scrapie isolates, ME7 and Rocky Mountain Laboratory (RML), in tga20 mice. These mice express elevated levels of PrP protein compared to wild-type mice and display a relatively short disease incubation period following intracerebral prion inoculation. Terminal prion disease in tga20 mice induced by ME7 or RML was characterized by a distinct pattern of clinical signs and different incubation times. High-dose RML inoculated intracerebrally into tga20 mice induced the most rapid onset of clinical signs, with mice succumbing to terminal disease after only 58 ± 3 days. In contrast, high-dose ME7 gave a mean time to terminal disease of 74 ± 0 days. Histological examination of brain sections from prion-inoculated tga20 mice at terminal disease showed that ME7 gave rise to a more general and extensive pattern of vacuolation than RML. Low-dose inoculum failed to induce terminal disease but did cause preclinical symptoms, including the appearance of reversible clinical signs. Some mice oscillated between showing no clinical signs and early clinical signs for many months but never progressed to terminal disease. Brain tissue from these mice with chronic subclinical prion disease, sacrificed at >200 days postinoculation, contained high levels of infectivity and showed the presence of PrPSc. Parallel analysis of brain tissue from mice with terminal disease showed similar levels of infectivity and detectable PrPSc. These results show that high levels of infectivity and the presence of the abnormal isomer of PrP can be detected in mice with subclinical disease following low-dose prion inoculation.

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