Articles: patients.
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On February 6, 2015, the Supreme Court of Canada ruled that the prohibition of physician-assisted death (PAD) was unconstitutional for a competent adult person who "clearly consents to the termination of life" and has a "grievous and irremediable (including an illness, disease, or disability) condition that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition." The radically subjective nature of this ruling raises important questions about who will be involved and how this practice might be regulated. This paper aims to stimulate discussion about psychiatry's role in this heretofore illegal practice and to explore how psychiatry might become involved in end-of-life care in a meaningful, patient-centred way. First, I will review existing international legislation and professional regulatory standards regarding psychiatry and PAD. Second, I will discuss important challenges psychiatry might face regarding capacity assessment, the notion of rational suicide, and the assessment of suffering.
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Observational Study
Living Donor Liver Transplantation in Children: Surgical and Immunological Results in 250 Recipients at Université Catholique de Louvain.
To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. ⋯ LDLT, including ABO-mismatched transplantation, constitutes a safe and efficient therapy for liver failure in children. In BA patients with PV hypoplasia, portoplasty seems to constitute the best technique for PV reconstruction. Maternal donation might be a protective factor for AR.
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Critical care medicine · Dec 2015
Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit.
To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection. ⋯ In this large cohort of critically ill patients, underweight was independently associated with a higher hazard of 60-day in-hospital death and overweight with a lower hazard. None of the body mass index categories as independently associated with an increased hazard of infection during the ICU stay.
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Clinical Trial
Role of copeptin in dual-cardiac marker strategy for patients with chest pain presented to ED.
The objective of the study is to evaluate the role of copeptin in the diagnosis of acute coronary syndrome (ACS) and its role in dual-cardiac marker diagnostic strategy with troponin. ⋯ Addition of copeptin to troponin does not have significant improvement of the diagnostic accuracy of ACS in patients presented with chest pain.
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Health care costs continue to increase, and the approach of countries and insurers is to focus on the value of the care delivered. Value is a function of quality in relation to costs. ⋯ The patients' perspectives include out-of-pocket expenses and work lost for both patients and potentially caregivers. The authors provide one example in the area of sleep apnea in which the anesthesiologist can provide value uniquely by being part of the team making the diagnosis.