Osler Centenary Papers: Management of pleural infection: Osler’s final illness and recent advances

2019 ◽  
Vol 95 (1130) ◽  
pp. 656-659 ◽  
Author(s):  
Prudence Gregory ◽  
Najib M Rahman ◽  
Y C Gary Lee
Keyword(s):  
Supportive Care ◽  
State Of The Art ◽  
Symptom Control ◽  
Lung Abscess ◽  
Surgical Drainage ◽  
Influenza Epidemic ◽  
Great Work ◽  
Contemporary State ◽  
Spanish Influenza ◽  
Pleural Infection

Sir William Osler’s great work and achievements are extensively documented. Less well known is his prolonged battle with postinfluenza pneumonia, lung abscess and pleural infection that eventually led to his demise. At the age of 70, he was a victim of the global Spanish influenza epidemic, and subsequently developed pneumonia. In the era before antibiotics, he received supportive care and opium for symptom control. The infection extended to the pleura and he required repeated thoracentesis which failed to halt his deterioration. He proceeded to open surgical drainage involving rib resection. Unfortunately, he died shortly after the operation from massive pleuropulmonary haemorrhage. In this article, we review the events leading up to Osler’s death and contrast his care 100 years ago with contemporary state-of-the-art management in pleural infection.

Pleural infection and lung abscess

2013 ◽  
pp. 215-221
Author(s):  
Amelia Clive ◽  
Clare Hooper ◽  
Nick Maskell
Keyword(s):  
Lung Abscess ◽  
Pleural Infection

Pleural infection, necrotising pneumonia and lung abscess

2013 ◽  
pp. 258-265 ◽  
Author(s):  
Fernando M. de Benedictis ◽  
Chiara Azzari ◽  
Filippo Bernardi
Keyword(s):  
Lung Abscess ◽  
Pleural Infection

Supportive Care Needs of Patients with Head and Neck Cancer Referred to Palliative Medicine

2020 ◽  
Vol 163 (2) ◽  
pp. 356-363
Author(s):  
Chen Lin ◽  
Stephen Y. Kang ◽  
Samantha Donermeyer ◽  
Theodoros N. Teknos ◽  
Sharla M. Wells-Di Gregorio
Keyword(s):  
Quality Of Life ◽  
Substance Use ◽  
Head And Neck Cancer ◽  
Supportive Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
Palliative Medicine ◽  
Symptom Control ◽  
Case Series

Objective Patients with head and neck cancer (HNC) face a unique set of unmet needs. A subset of these patients experience symptom control challenges related to their disease burden and treatments. A multidisciplinary approach involving palliative medicine is underutilized but crucial to identify and address these concerns. There is limited information on palliative integration with head and neck oncology. Study Design Case series with planned data collection. Setting Academic quaternary care center. Subjects and Methods We provide descriptive analyses of patients with HNC, including psychodiagnostic assessment and validated quality-of-life screening, from patients’ first encounter at outpatient palliative medicine. Results HNC (N = 80) contributed the greatest number of palliative referrals (25%) between 2010 and 2012. This cohort was 74% male and 79% Caucasian with a mean age of 53 years (95% CI, 51.1-54.9) and with stage IV disease of the oral cavity (28%) or oropharynx (31%). Sixty-three percent of patients had no evidence of disease. Seventy-five percent had a psychological history based on DSM-IV criteria ( Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), and 70% had a history of substance use disorder. The most distressing quality-of-life concerns were pain, housing and financial problems, and xerostomia. Conclusions Patients with HNC who were referred to palliative medicine are burdened by multiple physical, psychological, substance use, and social challenges. We recommend comprehensive cancer-specific screening, such as the James Supportive Care Screening, to triage patients to appropriate supportive care services. Palliative care is one of many services that these patients may need, and it should be utilized at any point of the disease trajectory rather than reserved for end-of-life care.

Supportive care for patients with pancreatic adenocarcinoma: symptom control and nutrition

2002 ◽  
Vol 16 (1) ◽  
pp. 105-121 ◽  
Author(s):  
Neil M Ellison ◽  
Eric Chevlen ◽  
Christopher D Still ◽  
Srinivastan Dubagunta
Keyword(s):  
Supportive Care ◽  
Pancreatic Adenocarcinoma ◽  
Symptom Control

Comparability of the Cancer Supportive Care Clinical Studies Collaborative (CSCCSC) study population to national referrals to other specialist palliative care services.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 63-63
Author(s):  
David Christopher Currow ◽  
Hiromichi Matsuoka ◽  
Samuel Allingham ◽  
Belinda Fazekas ◽  
Linda Brown ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Clinical Studies ◽  
Symptom Control ◽  
Population Characteristics ◽  
Phase Iii ◽  
Trial Participation ◽  
Care Services ◽  
Significant Difference ◽  
Palliative Care Services

63 Background: There are no agreed national nor international criteria for referral to palliative care. Key population characteristics have been defined to aid the generalizability of research findings in palliative care clinical studies. To codify differences in key demographic factors between patients with cancer participating in the Australian national Cancer Supportive Care Clinical Studies Collaborative (CSCCSC) phase III symptom control studies and the population referred to other Australian palliative care services. Methods: This study compares two contemporaneous consecutive cohorts generated through clinical trial participation and the national palliative care clinical quality improvement registry in Australia. Age, sex, cancer diagnosis, language, and socio-economic status were compared. Results: Cohorts were people with cancer: enrolled in CSCCSC phase III clinical studies (n=902; 17 sites); and registered by the Australian national Palliative Care Outcomes Collaboration (PCOC; n=75,240; 117 sites). Participants in CSCCSC studies were younger than those of PCOC (median 71 (IQR 62, 79) versus median 73 (IQR 63, 81); p=0.003 respectively). There was no significant difference in sex (p=0.483). Patients who spoke English accounted 95.0% of enrollees in the CSCCSC group and 92.2% in the PCOC group (p = 0.004). Clinical study participants had higher socioeconomic status that the PCOC group (p=0.022). Conclusions: Overall, the slightly different demographic patterns are reflective of the differences often seen between phase III trials and the populations to whom the results will be applied. Age differences particularly need to be taken into account when considering the best way to apply each study’s findings.

scholarly journals TIME-VARYING LINEARIZATION AND THE PERRON EFFECTS

2007 ◽  
Vol 17 (04) ◽  
pp. 1079-1107 ◽  
Author(s):  
G. A. LEONOV ◽  
N. V. KUZNETSOV
Keyword(s):  
State Of The Art ◽  
Time Varying ◽  
Present Survey ◽  
Contemporary State

In the present survey, the contemporary state of the art of the problem of the justification of nonstationary linearizations is presented.

Exploring the Research Domain of IT Governance in the SME Context

2016 ◽  
Vol 7 (1) ◽  
pp. 20-35 ◽  
Author(s):  
Tim Huygh ◽  
Steven De Haes
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
State Of The Art ◽  
It Governance ◽  
The State ◽  
Future Research ◽  
Research Strategies ◽  
Contemporary State ◽  
Review Procedure ◽  
Research Domain

This research aims to explore the research domain of IT governance in the SME context. To meet this objective, a small systematic literature review procedure is used. Results indicate that IT governance in the SME context has been researched previously, albeit not extensively. There seems to be consensus among authors that IT governance is important for SMEs as well as larger organizations. Additionally, many authors indicate that SME specificities will likely influence the nature and implementation of IT governance in the SME context. There also appears to be no great variety in research strategies used in this niche research domain. Regarding the contemporary state of IT governance in SMEs, authors seem to indicate that there is room for improvement. Finally, there is no published framework for IT governance that is tailored for SMEs, although the need for this is directly reported in the literature. This paper concludes by discussing some potential directions for future research, starting from the state-of-the-art of the research domain.

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