scholarly journals Admission of a Terminally Ill Lung Cancer Patient With the Accidental Diagnosis of SARS-CoV-2 to a Palliative Care Unit Resulting in a SARS-CoV-2 Outbreak

2021 ◽  
Vol 69 (12) ◽  
pp. 580-584
Author(s):  
Carmen Roch ◽  
Ulrich Vogel ◽  
Katharina Smol ◽  
Steffen Pörner ◽  
Birgitt van Oorschot

The COVID-19 pandemic poses challenges for palliative care. Terminal patients cannot wear masks and may demonstrate unspecific symptoms reminiscent of those caused by COVID-19. This report is about a terminally ill patient with lung cancer who displayed fever, cough, and fatigue. During hospital admission screening, the patient tested negative for SARS-CoV-2. When admitting his wife to stay with him, she also had to test for SARS-CoV-2 and displayed a positive test result. Until the positive results were reported, six staff members were infected with SARS-CoV-2, even though they were routinely wearing respirators. This resulted in the palliative care unit having to be closed. Hospitals need strict and adequate testing and re-testing strategies even for intra-hospital transfers. Workers must strictly adhere to recommended respirator practices. Ventilation of patient rooms is essential due to the possible enrichment of particle aerosols containing viruses, as negative pressure rooms are not recommended in all countries.

2019 ◽  
Vol 21 (2) ◽  
pp. 93
Author(s):  
Derya Kizilgoz ◽  
Havva Yeşildağlı ◽  
PinarAkin Kabalak ◽  
Tubaİnal Cengiz ◽  
Ülkü Yilmaz

1991 ◽  
Vol 7 (4) ◽  
pp. 5-8 ◽  
Author(s):  
Robin L. Fainsinger ◽  
Eduardo Bruera

Hypodermoclysis (HDC) is a well-known method of providing symptom control in terminally ill patients. In this article we make reference to two previous reports describing our use of HDC and a new method of subcutaneous narcotic delivery called the Edmonton Injector (El). The rationale for using HDC mainly for rehydration and the El when subcutaneous narcotics are needed is explored. The controversy surrounding the treatment of dehydration in the terminally ill is examined. Finally, the advantages on our palliative care unit of the convenience, increased flexibility, and cost and time saving of these two treatment methods are discussed.


2015 ◽  
Vol 13 (6) ◽  
pp. 1695-1700 ◽  
Author(s):  
Seon Hee Kim ◽  
In Cheol Hwang ◽  
Ki Dong Ko ◽  
Young Eun Kwon ◽  
Hong Yup Ahn ◽  
...  

ABSTRACTObjective:Several factors associated with referral time to hospice and/or palliative care services have been identified, but there is no literature on the association between these services and the emotional status of the family caregivers (FCs). This article is intended to address that issue.Method:A semistructured interview was employed to collect data for a retrospective cohort study. The primary FCs of terminally ill cancer patients were interviewed at the time of the patient's referral to the palliative care unit. Interview data were combined with patients' medical record data for our analysis. The emotional status of the FCs was categorized into one of three groups according to their responses to the anticipated death of their family member: acceptance, anxious/depressed, and denial/angry. A Cox proportional hazard model was used to examine and identify the factors related to the length of stay (LOS) in the palliative care unit.Results:A total of 198 patient–FC pairs were identified. The median LOS was 18 days. A multivariate analysis with adjustment for potential variables revealed significant differences in LOS according to cancer type and time since cancer diagnosis. The denial/angry FC category was independently associated with a shorter LOS (vs. acceptance, adjusted hazard ratio (aHR) 2.11; 95% confidence interval (CI), 1.11–4.03).Significance of Results:We found that terminally ill cancer patients who were referred late had FCs who were in denial or were angry about the anticipated death of their loved one. The emotional status of FCs should be considered when patients with terminal cancer are referred to palliative care.


1989 ◽  
Vol 3 (3) ◽  
pp. 115-118 ◽  
Author(s):  
James R. Gray ◽  
Urs P. Steinbrecher

This report describes a patient with autoimmune hepatitis in whom a positive test result for hepatitis A virus (HAV) IgM antibody led to diagnostic confusion until it was shown to be false positive by immunoprecipitation of IgG from serum. The mechanism for the false positive result may have been related to marked hypergammaglobulinemia, as serum obtained after normalization of immunoglobulin levels tested negative. However, several other mechanisms were also considered. This case illustrates that the possibility of false positive results with the anti-HAV lgM assay should be kept in mind when the clinical features of the illness are not suggestive of acute hepatitis A.


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