Genomes and Genes
Summary: Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.
Publications227 found, 100 shown here
- Can tyrosine kinase inhibitors be discontinued in patients with metastatic renal cell carcinoma and a complete response to treatment? A multicentre, retrospective analysisManfred Johannsen
Department of Urology, Charite Universitatsmedizin Berlin, Berlin, Germany
Eur Urol 55:1430-8. 2009....
- Death after withdrawal from dialysis: the most common cause of death in a French dialysis populationBéatrice Birmelé
Néphrologie Immunologie Clinique, CHRU Bretonneau, Tours, France
Nephrol Dial Transplant 19:686-91. 2004..The aim of this retrospective study was to characterize withdrawal from dialysis in a French population cohort...
- Extended oral anticoagulant therapy after a first episode of pulmonary embolismGiancarlo Agnelli
Sezione di Medicina Interna e Cardiovascolare, Dipartimento di Medicina Interna, Universita di Perugia, Via Enrico Dal Pozzo, 06123 Perugia, Italy
Ann Intern Med 139:19-25. 2003..The optimal duration of oral anticoagulant treatment after a first episode of pulmonary embolism remains uncertain...
- Country, sex, EDSS change and therapy choice independently predict treatment discontinuation in multiple sclerosis and clinically isolated syndromeClaire Meyniel
Department of Neurology, Royal Melbourne Hospital, Victoria, Australia
PLoS ONE 7:e38661. 2012..We conducted a prospective study, MSBASIS, to assess factors leading to first treatment discontinuation in patients with a clinically isolated syndrome (CIS) and early relapsing-remitting multiple sclerosis (RRMS)...
- A prospective clinical study in hepatitis B e antigen-negative chronic hepatitis B patients with stringent cessation criteria for adefovirMinghao Ha
Department of Infectious Diseases and Hepatology, Shanghai No 7 hospital, Shanghai 200137, China
Arch Virol 157:285-90. 2012..HBsAg seroconversion is the ideal endpoint of adefovir treatment...
- The types of neurological deficits might not justify withholding treatment in patients with low total National Institutes of Health Stroke Scale scoresEnrique C Leira
Division of Cerebrovascular Diseases, Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
Stroke 43:782-6. 2012....
- MRI and withdrawal of life support from newborn infants with hypoxic-ischemic encephalopathyDominic Wilkinson
Department of Public Health and Primary Health Care, Ethox Centre, University of Oxford, Badenoch Building, Headington, UK
Pediatrics 126:e451-8. 2010..There is an urgent need for improved prognostic research into HIE...
- Treatment interruption in a primary care antiretroviral therapy program in South Africa: cohort analysis of trends and risk factorsKatharina Kranzer
The Desmond Tutu HIV Centre, Institute for Infectious Disease and Molecular Medicine, Faculty of Health Science, University of Cape Town, South Africa
J Acquir Immune Defic Syndr 55:e17-23. 2010..To investigate antiretroviral treatment (ART) interruption in a long-term treatment cohort in South Africa...
- The risk for fatal pulmonary embolism after discontinuing anticoagulant therapy for venous thromboembolismJames D Douketis
McMaster University, Hamilton, Ontario, Canada
Ann Intern Med 147:766-74. 2007..The long-term risk for fatal pulmonary embolism (PE) after treatment of venous thromboembolism (VTE) may be an important factor in the decision to discontinue this treatment...
- Ethical issues in intensive care--a survey among Scandinavian intensivistsM Tallgren
Department of Anaesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland
Acta Anaesthesiol Scand 49:1092-100. 2005....
- Withdrawing may be preferable to withholdingJean Louis Vincent
Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium
Crit Care 9:226-9. 2005..In this article, I will provide arguments why, although the two actions are indeed ethically equivalent, withdrawing life-sustaining therapy may in fact be preferable to withholding...
- Analysis of terminal events in 109 successive deaths in a Belgian intensive care unitKalina Gajewska
Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium
Intensive Care Med 30:1224-7. 2004..To determine the incidence of end-of-life decisions in intensive care unit (ICU) patients...
- Use of feeding tubes in nursing home residents with severe cognitive impairmentJoan M Teno
JAMA 287:3211-2. 2002
- Epistaxis as the reason for premature discontinuation of clopidogrel after percutaneous coronary angioplasty with stent implantationEdyta Jura-Szołtys
Department of Laryngology, Silesian Medical University, Katowice, Poland
Kardiol Pol 69:817-23. 2011..Haemorrhagic complications, including epistaxis, are the main reason for discontinuation of antiplatelet therapy in patients after stent implantation which increases risk of in-stent thrombosis...
- Nurse involvement in end-of-life decision making: the ETHICUS StudyJulie Benbenishty
Hadassah Medical Organization, Jerusalem, Israel
Intensive Care Med 32:129-32. 2006..The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making...
- Advance care planning for fatal chronic illness: avoiding commonplace errors and unwarranted sufferingJoanne Lynn
Center for Palliative Care Studies, The Washington Home Center for Palliative Care Studies and RAND Health, Washington, DC 20016, USA
Ann Intern Med 138:812-8. 2003..Reliable improvement will also require making it unacceptable for clinicians to fail to plan ahead for care during fatal chronic illness...
- Reasons, considerations, difficulties and documentation of end-of-life decisions in European intensive care units: the ETHICUS StudyCharles L Sprung
Hadassah Hebrew University Medical Center, General Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, P O Box 12000, 91120 Jerusalem, Israel
Intensive Care Med 34:271-7. 2008..To evaluate physicians' reasoning, considerations and possible difficulties in end-of-life decision-making for patients in European intensive care units (ICUs)...
- Clinical response in psoriasis patients discontinued from and then reinitiated on etanercept therapyKenneth B Gordon
Loyola University, Maywood, IL, USA
J Dermatolog Treat 17:9-17. 2006....
- Patient involvement in decisions to limit treatment: the crucial role of agreement between physician and patientEva C Winkler
Department of Internal Medicine III, University Hospital Grosshadern, Ludwig Maximilians University, 81377 Munich, Germany
J Clin Oncol 27:2225-30. 2009....
- Futility and rationingN S Jecker
Department of Medical History and Ethics, University of Washington School of Medicine, Seattle 98195
Am J Med 92:189-96. 1992..Rationing always occurs against a backdrop of resource scarcity, but futility need not. Toward the end of the paper, we clarify how the various connotations and contexts we associate with each term enhance or frustrate ethical debate...
- Withdrawal of care in JapanKaoruko Aita
Department of Social Gerontology, School of Health Sciences and Nursing, The University of Tokyo, 7 3 1 Hongo, Bunkyo ku, Tokyo 113 0033, Japan
Lancet 368:12-4. 2006
- Are terminally ill patients dying in the ICU suitable for non-heart beating organ donation?Jean Pierre Revelly
Surgical Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland
Intensive Care Med 32:708-12. 2006..To evaluate the feasibility of implementing a program of controlled non-heart beating organ donation, in patients undergoing the withdrawal of intensive care treatment...
- Outcome of patients who have therapy withheld or withdrawn in ICUJ P Lewis
Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia, Australia
Anaesth Intensive Care 35:387-92. 2007..Long-term survival in critically ill patients who had life support limitations was very rare in this ICU...
- Efficacy and safety of atazanavir, with or without ritonavir, as part of once-daily highly active antiretroviral therapy regimens in antiretroviral-naive patientsD R Malan
Triple M Research, Port Elizabeth, South Africa
J Acquir Immune Defic Syndr 47:161-7. 2008..Study AI424-089 was a prospective, randomized, open-label, 96-week study comparing 2 ATV-based treatment regimens in ARV-naive HIV-infected patients...
- The legal framework for end of life care: a United Kingdom perspectiveDominic Bell
Intensive Care Anaesthesia, General Infirmary at Leeds, Great George Street, LS1 3EX, Leeds, UK
Intensive Care Med 33:158-62. 2007
- Reasons for stopping antiretrovirals used in an initial highly active antiretroviral regimen: increased incidence of stopping due to toxicity or patient/physician choice in patients with hepatitis C coinfectionA Mocroft
Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, NW3 2PF UK
AIDS Res Hum Retroviruses 21:743-52. 2005..Managing adverse events must remain a key intervention in maintaining HAART. There is a need for further studies to describe the relationship between HCV, specific antiretrovirals, and different treatment strategies...
- End-of-life decisions: a cohort study of the withdrawal of all active treatment in intensive care units in the United KingdomHannah Wunsch
Department of Anesthesiology, Columbia University, New York Presbyterian Hospital, New York, NY 10025, USA
Intensive Care Med 31:823-31. 2005..To describe the epidemiology of active treatment withdrawal in a nationally representative cohort of intensive care units (ICUs) focusing on between-unit differences...
- Withholding treatment, withdrawing treatment, and palliative care in the neonatal intensive care unitFrans J Walther
Neonatal Center, Department of Pediatrics, Leiden University Medical Center, J6 S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
Early Hum Dev 81:965-72. 2005..Perinatal audit and after-care of the family complete the process. The Dutch viewpoint and practice guidelines on withholding and withdrawing of neonatal intensive care are presented...
- Discontinuation of postmenopausal hormone therapyDeborah Grady
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
Am J Med 118:163-5. 2005..For women who cannot tolerate even a slow taper, the value of symptom relief likely outweighs any increased risks due to HT use...
- End-of-life decisions in Swedish ICUs. How do physicians from the admitting department reason?Mia Svantesson
Department of Anesthesia and Intensive Care, Centre for Caring Sciences, Orebro University Hospital, SE 701 85 Orebro, Sweden
Intensive Crit Care Nurs 19:241-51. 2003..To study how physicians from the admitting department reason during the decision-making process to forego life-sustaining treatment of patients in intensive care units (ICUs)...
- The contribution of withholding or withdrawing care to newborn mortalityLorayne Barton
Division of Newborn Medicine, Department of Pediatrics, Keck School of Medicine, University of Southern California, Women s and Children s Hospital, Los Angeles, California, USA
Pediatrics 116:1487-91. 2005..We sought to determine the contribution of withholding or withdrawing care to neonatal mortality in our hospital over a 10-year period from 1993 through 2002...
- Forgoing life sustaining treatments: differences and similarities between North America and EuropeN M Moselli
Unit of Anaesthesiology, Intensive Care and Pain Therapy, Institute for Cancer Research and Treatment IRCC, Candiolo Torino, Italy
Acta Anaesthesiol Scand 50:1177-86. 2006..The objective of this review is to examine policies and attitudes towards end-of-life decisions in Europe and North America and to outline differences and similarities...
- DNR directives are established early in mechanically ventilated intensive care unit patientsTasnim Sinuff
Department of Medicine, McMaster University Health Sciences Center, Room 2C11, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada
Can J Anaesth 51:1034-41. 2004..Our objective was to study the rate of establishing do-not-resuscitate (DNR) directives, determinants, and outcomes of those directives for mechanically ventilated patients...
- Parental role in medical decision-making: fact or fiction? A comparative study of ethical dilemmas in French and American neonatal intensive care unitsKristina Orfali
MacLean Center for Clinical Medical Ethics, The University of Chicago, 5841 S Maryland Avenue, MC 6098, Chicago, IL 6098, USA
Soc Sci Med 58:2009-22. 2004..The study provides an analysis of the making of "ethics", with an emphasis on how decisions are conceptualized as ethical dilemmas. The final conclusion is that the ongoing medical authority on ethics remains the key issue...
- Decision making and modes of death in a tertiary neonatal unitR Roy
Homerton University Hospital, London E9 6SR, UK
Arch Dis Child Fetal Neonatal Ed 89:F527-30. 2004..To study the frequency and reason for withdrawal/withholding of life sustaining treatment (LST) and do not resuscitate (DNR) orders in infants who died in a tertiary neonatal unit...
- Legal basis for ethical withholding and withdrawing life-sustaining medical treatment from infants and childrenJames Tibballs
Intensive Care Unit and Department of Paediatrics, Royal Children s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
J Paediatr Child Health 43:230-6. 2007..These legal principles may facilitate difficult ethical decisions. This article identifies a number of common law cases which establishes these principles...
- Tube feedings and persistent vegetative state patients: ordinary or extraordinary means?Peter Clark
Department of Theology, Saint Joseph s University, 5600 City Avenue, Philadelphia, PA 19135 1395, USA
Christ Bioeth 12:43-64. 2006..Moreover, additional analysis is needed to determine whether the papal allocution is in conflict with the traditional Catholic medical ethics understanding of the ordinary-extraordinary care distinction...
- Harm and uncertainty in newborn intensive careKenneth Kipnis
Department of Philosophy, University of Hawaii at Manoa, 2530 Dole Street, Honolulu, HI 96822, USA
Theor Med Bioeth 28:393-412. 2007..Though treatment may offer a reasonable chance of a good outcome, it is argued that there are situations in which neonatologists should nonetheless defer to parental nontreatment decisions...
- Withdrawing and withholding life support in the intensive care unit: a Spanish prospective multi-centre observational studyA Esteban
Hospital Universitario de Getafe, Carretera de Toledo Km 12, 500, Getafe 28905, Madrid, Spain
Intensive Care Med 27:1744-9. 2001..To determine how frequently life support is withheld or withdrawn from adult critically ill patients, and how physicians and patients families agree on the decision regarding the limitation of life support...
- Flaws in the assessment of the best interests of the newbornCarlo V Bellieni
Department of Pediatrics, Obstetrics and Reproduction Medicine, University of Siena, Italy
Acta Paediatr 98:613-7. 2009..In most cases, parents' opinions are considered important and are sometimes the main determinant in decision making. However, it is unclear whether parents' decisions are based on their own wishes or on the best interests of the newborn...
- Decisions for life made in the perinatal period: who decides and on which standards?Jag Ahluwalia
Rosie Hospital, Addenbrooke s NHS Trust, Hills Road, Cambridge CB2 0QQ, UK
Arch Dis Child Fetal Neonatal Ed 93:F332-5. 2008
- Racial and ethnic differences in preferences for end-of-life treatmentAmber E Barnato
Center for Research on Health Care, University of Pittsburgh, 200 Meyran Avenue, Suite 200, Pittsburgh, PA, 15312, USA
J Gen Intern Med 24:695-701. 2009..These studies are limited by size, representation, and insufficient exploration of sociocultural covariables...
- Functional neuroimaging and withdrawal of life-sustaining treatment from vegetative patientsD J Wilkinson
Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
J Med Ethics 35:508-11. 2009..Although functional neuroimaging is likely to play an increasing role in the assessment of patients in a vegetative state, caution is needed in the interpretation of neuroimaging findings...
- End-of-life decision before and after birth: changing ethical considerationsAndrew B Pinter
Department of Paediatrics, University of Pecs, 7623 Pecs, Hungary
J Pediatr Surg 43:430-6. 2008....
- End-of-life decisions in Dutch neonatal intensive care unitsA A Eduard Verhagen
Department of Pediatrics, University Medical Centre, 9700 RB Groningen, The Netherlands
Arch Pediatr Adolesc Med 163:895-901. 2009..To clarify the practice of end-of-life decision making in severely ill newborns...
- The Terri Schiavo case: legal, ethical, and medical perspectivesJoshua E Perry
Vanderbilt University, Nashville, Tennessee, USA
Ann Intern Med 143:744-8. 2005....
- Potential for donation after cardiac death in a children's hospitalAmy L Durall
Division of Critical Care, Department of Anesthesia, Perioperative and Pain Medicine, Children s Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA
Pediatrics 119:e219-24. 2007..As part of this process, we sought to determine the number of potential kidney donation after cardiac death donors in our PICUs...
- Neonatal end-of-life care: a review of the research literatureTeresa Moro
University of Chicago, School of Social Service Administration, IL 60612, USA
J Perinat Neonatal Nurs 20:262-73. 2006....
- Is it in the best interests of an intellectually disabled infant to die?D Wilkinson
Mercy Hospital for Women, PO Box 5027, Heidelberg West, Victoria 3081, Australia
J Med Ethics 32:454-9. 2006..The best interests of the child can be affected by severe or profound intellectual disability. It is, though, not as clear-cut as some might expect...
- Withholding and withdrawal of life-sustaining treatment in a Lebanese intensive care unit: a prospective observational studyAlexandre Yazigi
Department of Anesthesiology and Surgical Intensive Care, Hotel Dieu de France Hospital, Saint Joseph University, Adib Ishac Street, Beirut, Lebanon
Intensive Care Med 31:562-7. 2005..To evaluate the implementation and process of withholding and withdrawing life-sustaining treatment in an intensive care unit...
- EfCCNa survey: European intensive care nurses' attitudes and beliefs towards end-of-life careJos M Latour
Clinical Researcher, Paediatric Intensive Care Unit, Erasmus MC Sophia Children s Hospital, Rotterdam, The Netherlands
Nurs Crit Care 14:110-21. 2009..Few studies have examined the involvement of European intensive care nurses' involvement in EOL care decisions and the extent to which their nursing practice is based on shared beliefs, experiences and attitudes...
- Death in the neonatal intensive care unit: changing patterns of end of life care over two decadesD J Wilkinson
Department of Neonatology, Royal Children s Hospital, Parkville, Melbourne, Victoria 3052, Australia
Arch Dis Child Fetal Neonatal Ed 91:F268-71. 2006..Death remains a common event in the neonatal intensive care unit, and often involves limitation or withdrawal of life sustaining treatment...
- Circumstances surrounding end of life in a pediatric intensive care unitDaniel Garros
Department of Critical Care Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Pediatrics 112:e371. 2003..Approximately 60% of deaths in pediatric intensive care units follow limitation or withdrawal of life-sustaining treatment (LST). We aimed to describe the circumstances surrounding decision making and end-of-life care in this setting...
- Circumstances surrounding the deaths of hospitalized children: opportunities for pediatric palliative careBrian S Carter
Vanderbilt Children s Hospital, Vanderbilt University School of Medicine, TN, USA
Pediatrics 114:e361-6. 2004..This study was conducted to describe the circumstances surrounding the deaths of hospitalized terminally ill children, especially pain and symptom management by the multidisciplinary pediatric care team...
- The reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent does not influence the effect of a second TNF blocking agent in patients with rheumatoid arthritisMarlies Blom
Department of Rheumatology, Radboud University Nijmegen Medical Centre, PO Box 9101, H 470, 6500 HB Nijmegen, The Netherlands
J Rheumatol 36:2171-7. 2009..To investigate whether the reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent influences the effect of a second TNF blocking agent...
- Conflicts about end-of-life decisions in NICUs in the NetherlandsA A Eduard Verhagen
Department of Pediatrics, Beatrix Children s Hospital, University Medical Center Groningen, Groningen, Netherlands
Pediatrics 124:e112-9. 2009..To determine the frequency and background of conflicts about neonatal end-of-life (EoL) decisions...
- End-of-life after birth: death and dying in a neonatal intensive care unitJaideep Singh
Department of Pediatrics, University of Chicago, and the MacLean Center for Clinical Medical Ethics, Chicago, Illinois 60637, USA
Pediatrics 114:1620-6. 2004..We hypothesized that clarifying them would more accurately portray the process of end-of-life decision-making in the NICU...
- Noninitiation or withdrawal of intensive care for high-risk newbornsEdward F Bell
Pediatrics 119:401-3. 2007....
- Futility: a concept in evolutionJeffrey P Burns
Division of Critical Care Medicine, Department of Anesthesia, Children s Hospital Boston and Harvard Medical School, Boston, MA 02115, USA
Chest 132:1987-93. 2007....
- Are newborns morally different from older children?Annie Janvier
McGill University, Montreal, Quebec, Canada
Theor Med Bioeth 28:413-25. 2007....
- Terminal sedation: source of a restless ethical debateJohannes J M van Delden
J Med Ethics 33:187-8. 2007
- Discussing withholding and withdrawing of life-sustaining medical treatment in paediatric inpatients: audit of current practiceZornitza Stark
Department of Clinical Quality and Safety, Royal Children s Hospital, Melbourne, Victoria, Australia
J Paediatr Child Health 44:399-403. 2008....
- The legal framework for end-of-life decisions in the UKJanet M Rennie
UCL Elizabeth Garrett Anderson Institute for Women s Health, University College London Hospitals, London, UK
Semin Fetal Neonatal Med 13:296-300. 2008..Legal proceedings should be used only as a last resort...
- Withdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literaturePeter Moore
Orange Base Hospital, Orange, Australia
J Paediatr Child Health 44:404-8. 2008..To examine withdrawal and limitation of life-sustaining treatment (WLST) in an Australian paediatric intensive care unit (PICU) and to compare this experience with published data from other countries...
- Systematic review: D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolismMadeleine Verhovsek
McMaster University and St Joseph s Hospital, Hamilton, Ontario, Canada
Ann Intern Med 149:481-90, W94. 2008..Methods for predicting risk for recurrence may identify low-risk patients who are less likely to benefit from prolonged anticoagulation...
- HIV-1 transmission after cessation of early antiretroviral therapy among men having sex with menPhilip Rieder
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
AIDS 24:1177-83. 2010..To study transmission dynamics during acute infection, during the aviremic phase over the period of early antiretroviral therapy (ART) and during the phase of viral rebound after early treatment was stopped...
- Parental refusal of medical treatment for a newbornJohn J Paris
Boston College, Chestnut Hill, MA 02167, USA
Theor Med Bioeth 28:427-41. 2007..We conclude with support for the policy articulated in the 2007 guidelines of the American Academy of Pediatrics on non-intervention or withdrawal of intensive care for high-risk newborns...
- Withdrawal of medical treatment in the ICU. A cohort study of 318 cases during 1994-2000T Nolin
Department of Anaesthesiology, Central Hospital, Kristianstad, Sweden
Acta Anaesthesiol Scand 47:501-7. 2003..The aim of this study was to determine the incidence of decisions to withdraw medical therapy in a Swedish, general intensive care unit (ICU), the underlying reasons and outcomes...
- Time course of adverse events most commonly associated with topiramate for migraine preventionM J A Lainez
University Clinic Hospital, University of Valencia, Valencia, Spain
Eur J Neurol 14:900-6. 2007..AEs leading to discontinuation of topiramate are probably to occur during dose titration. If a patient has not experienced one of these AEs within the first 6 weeks of initiating topiramate 100 mg/day, these AEs are unlikely to occur...
- End-of-life practices in the Netherlands under the Euthanasia ActAgnes van der Heide
Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
N Engl J Med 356:1957-65. 2007..In 2005, we performed a follow-up study of euthanasia, physician-assisted suicide, and other end-of-life practices...
- End-of-life practices in 282 intensive care units: data from the SAPS 3 databaseElie Azoulay
Service de Reanimation Medicale, Hôpital Saint Louis et Université Paris 7, Assistance Publique, Hopitaux de Paris, Paris, France
Intensive Care Med 35:623-30. 2009..To report incidence and characteristics of decisions to forgo life-sustaining therapies (DFLSTs) in the 282 ICUs who contributed to the SAPS3 database...
- Practices of anaesthesiologists with regard to withholding and withdrawal of life support from the critically ill in TurkeyL Iyilikci
Department of Anaesthesiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
Acta Anaesthesiol Scand 48:457-62. 2004..To determine practices of Turkish anaesthesiologists with regard to withholding and withdrawal of life support from the critically ill...
- Evaluation of changes in forgoing life-sustaining treatment in Israeli ICU patientsDaniel J Jakobson
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, PO Box 12000, Jerusalem, Israel 91120, USA
Chest 126:1969-73. 2004..Over the last several years, there have been legal decisions and changes in medical directives concerning end-of-life decisions in Israel...
- Perinatal care at the threshold of viability: an international comparison of practical guidelines for the treatment of extremely preterm birthsMaria Serenella Pignotti
Neonatal Medicine, A Meyer Children s Hospital, University of Florence, Via Luca Giordano 13, 50132 Firenze, Italy
Pediatrics 121:e193-8. 2008....
- Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: the PROLONG II prospective studyBenilde Cosmi
Department of Angiology and Blood Coagulation, Marino Golinelli University Hospital St Orsola Malpighi, Bologna, Italy
Blood 115:481-8. 2010..9; 95% CI: 2.1-30; P = .002). Repeated D-d testing after anticoagulation suspension for a first episode of unprovoked VTE could help tailor the duration of treatment. This trial is registered at http://clinicaltrials.gov as NCT00266045...
- Ethical analysis of withdrawing ventricular assist device supportPaul S Mueller
Division of General Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
Mayo Clin Proc 85:791-7. 2010..To describe a series of patients with heart failure supported with a ventricular assist device (VAD) who requested (or whose surrogates requested) withdrawal of VAD support and the legal and ethical aspects pertaining to these requests...
- Survey of respiratory therapists' attitudes and concerns regarding terminal extubationDavid C Willms
Pulmonary Center, Sharp Memorial Hospital, 7901 Frost Street, San Diego CA 92123, USA
Respir Care 50:1046-9. 2005..There is little published information on the role of respiratory therapists in the process of withdrawal of mechanical ventilatory support...
- Within you/without you: biotechnology, ontology, and ethicsDaniel P Sulmasy
John J Conley Department of Ethics, St Vincent s Hospital Manhattan, 153 W 11th St, New York, NY, USA
J Gen Intern Med 23:69-72. 2008....
- Ethical and legal views of physicians regarding deactivation of cardiac implantable electrical devices: a quantitative assessmentDaniel B Kramer
Cardiovascular Institute, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02446, USA
Heart Rhythm 7:1537-42. 2010..Despite the high prevalence of pacemakers and implantable cardioverter-defibrillators, little is known about physicians' views surrounding the ethical and legal aspects of managing these devices at the end of life...
- Brain damage and the moral significance of consciousnessGuy Kahane
University of Oxford, Oxford, UK
J Med Philos 34:6-26. 2009..We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function...
- Infliximab continuation rates in patients with rheumatoid arthritis in everyday practiceDaniel Wendling
Rheumatology Department, Minjoz Teaching Hospital, CHU Minjoz, 25030 Besancon, France
Joint Bone Spine 72:309-12. 2005..Infliximab is a major breakthrough in the management of rheumatoid arthritis (RA). We evaluated infliximab continuation rates and reasons for discontinuation in patients with RA...
- Effect of decisions to withhold life support on prolonged survivalYen Yuan Chen
Department of Bioethics, Case Western Reserve University, Cleveland, OH, USA
Chest 133:1312-8. 2008..We hypothesized that mortality 60 days after ICU admission is not influenced by a decision to withhold use of LST in the context of otherwise providing all indicated care...
- Terri Schiavo--a tragedy compoundedTimothy E Quill
Center for Palliative Care and Clinical Ethics at the University of Rochester Medical Center, Rochester, NY, USA
N Engl J Med 352:1630-3. 2005
- Participation of French general practitioners in end-of-life decisions for their hospitalised patientsE Ferrand
Service d anesthésie réanimation Samu 94, Hopital Henri Mondor, AP HP 51, Avenue du Marechal de Lattre de Tassigny, 94010 Creteil Cedex, France
J Med Ethics 32:683-7. 2006....
- Assessment of strategies for switching patients from olanzapine to risperidone: a randomized, open-label, rater-blinded studyRohan Ganguli
Western Psychiatric Institute and Clinic, O Hara Street, Pittsburgh, PA 15213 2593, USA
BMC Med 6:17. 2008..This paper assesses the short-term results of strategies for the discontinuation of olanzapine when initiating risperidone...
- The importance of religious affiliation and culture on end-of-life decisions in European intensive care unitsCharles L Sprung
General Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, Medical Center, Hadassah Hebrew University, P O Box 12000, 91120, Jerusalem, Israel
Intensive Care Med 33:1732-9. 2007..To determine the influence of religious affiliation and culture on end-of-life decisions in European intensive care units (ICUs)...
- The impact of regional culture on intensive care end of life decision making: an Israeli perspective from the ETHICUS studyF D Ganz
Hadassah Hebrew University School of Nursing, Kiryat Hadassah, PO Box 12000, Jerusalem, Israel
J Med Ethics 32:196-9. 2006..Several results of the Israeli subsample were different to those of the overall sample...
- Deactivating implanted cardiac devices in terminally ill patients: practices and attitudesPaul S Mueller
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
Pacing Clin Electrophysiol 31:560-8. 2008..Clinicians may receive requests to deactivate pacemakers and implantable cardioverter-defibrillators (ICDs) in terminally ill patients...
- Withdrawal of cardiac medications and devicesDebra Lynn McHale Wiegand
University of Maryland School of Nursing, USA
AACN Adv Crit Care 18:415-25. 2007..Critical care nurses support each patient and his or her family and work with other members of the healthcare team to achieve a peaceful death...
- Moral fictions and medical ethicsFranklin G Miller
Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20892 1156, USA
Bioethics 24:453-60. 2010..When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken...
- Physicians' decisions to withhold and withdraw life-sustaining treatmentNeil J Farber
Department of Medicine, Christiana Care Health System, Wilmington, Delaware 19899, USA
Arch Intern Med 166:560-4. 2006..Few data are available about physicians' decisions in regard to withholding or withdrawing life-sustaining measures. We therefore studied internists' views on this subject...
- Interventions to improve care during withdrawal of life-sustaining treatmentsJ Randall Curtis
Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, Washington 98104 2499, USA
J Palliat Med 8:S116-31. 2005..Further research is needed to identify and test the most appropriate and responsive outcome measures and to identify the most effective and cost-effective interventions...
- Opioids and benzodiazepines appear paradoxically to delay inevitable death after ventilator withdrawalMiles J Edwards
Center for Ethics in HealthCare, Oregon Health and Science University, Portland, USA
J Palliat Care 21:299-302. 2005
- Ethics ain't easy: do we need simple rules for complicated ethical decisions?Annie Janvier
Paediatrics, McGill University, Montreal, Quebec, Canada
Acta Paediatr 97:402-6. 2008..Recommendations from national bodies regarding extremely preterm infants have focussed almost exclusively on thresholds for intervention based upon estimated gestational age (GA) alone...
- 'Death rattle' after withdrawal of mechanical ventilation: practical and ethical considerationsErwin J O Kompanje
Department of Intensive Care and Department of Medical Ethics, Erasmus MC University Medical Center, Room V 208, P O Box 2040, 3000 CA Rotterdam, The Netherlands
Intensive Crit Care Nurs 22:214-9. 2006..In practice, injectable scopolamine is the reference drug for symptomatic treatment of death rattle...
- Withdrawal of ventilatory support from the dying adult patientLisa Marr
Medical College of Wisconsin, Palliative Care Center, Division of Neoplastic Diseases and Related Disorders, Milwaukee, WI 53226, USA
J Support Oncol 2:283-8. 2004
- ICU nurses' preparation of families for death of patients following withdrawal of ventilator supportKarin T Kirchhoff
University of Wisconsin, School of Nursing, Madison, WI 53792 2455, USA
Appl Nurs Res 16:85-92. 2003....
- Withdrawing life support and resolution of conflict with familiesJenny Way
Department of Medicine, University of Washington, Seattle, WA 98195, USA
BMJ 325:1342-5. 2002
- Limitation of treatment at the end-of-life: withholding and withdrawalArthur R Derse
Center for the Study of Bioethics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 0509, USA
Clin Geriatr Med 21:223-38, xi. 2005..The circumstances in which end of life treatment may be ethically and legally limited through withholding or withdrawal are discussed...
- Management of implantable cardioverter defibrillators in end-of-life careNathan E Goldstein
Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut, USA
Ann Intern Med 141:835-8. 2004..Implantable cardioverter defibrillators (ICDs) can prevent premature death from an arrhythmia but may also prolong the dying process and make it more distressing...
- The ethics of deactivating implanted cardioverter defibrillatorsJeffrey T Berger
State University of New York Stony Brook School of Medicine, USA
Ann Intern Med 142:631-4. 2005..This paper discusses bioethical considerations in disabling implantable cardioverter defibrillators...
- Serpin Modulation of Inflammatory Vasculitis; Potential for Immunomodulatory TherALEXANDRA ROSE LUCAS; Fiscal Year: 2010..We have successfully tested one of these serpins, Serp-1, in a small phase 2A clinical trial for anti-inflammatory activity in unstable coronary syndromes (Viron Therapeutics, Inc;proprietary information). ..
- Bifunctional Redox Agent for the Treatment of PPHNGARRY JOHN SOUTHAN; Fiscal Year: 2011..We now propose to define the value of our technology in a definitive clinically-relevant animal model of PPHN. ..
- A Controlled Trial of CBT for Multiple Sclerosis InflammationDavid I Daikh; Fiscal Year: 2010..We also wilt enhance our understanding of mechanisms by examining potential psychosocial, immune, and endocrine mediators of the relationship betweenSLEs and clinical and neuroimaging markers of MS inflammation. ..
- ESTROGEN AND THE AGING BRAINJohn H Morrison; Fiscal Year: 2013..These results will provide critically important information on brain aging and will aid in the design of hormone treatments that provide maximal neurological benefits for post-menopausal women. ..
- Individualized Objective Techniques for Early Detection of OtotoxicityMARILYN FARNSWORTH contact DILLE; Fiscal Year: 2011..Further improvements, such as may be accomplished through the combined use of 2f1-f2 and 2f2-f1 DPOAEs or stimulus- frequency otoacoustic emissions, are also desirable for testing patients with greater hearing loss. ..
- Decision-making for Infants with Complex Life-Threatening ConditionsSharron L Docherty; Fiscal Year: 2012..The goal will be to identify transition points across the trajectory and provide a foundation for developing interventions to facilitate parents'decision-making for these infants. ..
- Immunomodulation for Heart Allograft ToleranceRichard N Pierson; Fiscal Year: 2013....
- Gene Discovery for Warfarin-Related Intracerebral HemorrhageJonathan Rosand; Fiscal Year: 2012..Thus, even relatively minor elevations in risk for ICH on warfarin can sway the balance in favor of withholding treatment. Accumulated evidence points to a strong familial contribution to ICH susceptibility...
- MODULATION OF MULTIDRUG RESISTANCE BY CYCLOSPORIN ACharles Erlichman; Fiscal Year: 1992..The proposed studies will evaluate the importance of P-glycoprotein in clinical resistance to MDR and determine whether cyclosporin A can reverse the MDR phenotype in patients...
- Expression of anti-HIV siRNA in Blood CellsJOHN JOSEPH ROSSI; Fiscal Year: 2013..The long term goal of these studies is the establishment of a method for activation of latent virus followed by selective purging of these cells from infected individuals, ultimately leading to a cure from HIV-1 infection. ..
- Role of CTL avidity in epitope variant recognition and immune control of HIVNicole Frahm; Fiscal Year: 2010....
- Cocaine behavior: Regulation by k-opioids and serotoninSari Izenwasser; Fiscal Year: 2009..abstract_text> ..
- Use of Chronoamperometry to Measure Extracellular 5 HTAlan Frazer; Fiscal Year: 2005..These experiments involve multiple approaches to study an effect of specific antidepressant drugs that may be very important in sustaining the enhancement of monoaminergic transmission that underlies clinical improvement ..
- Metabolic Polymorphisms and Survival from Brain TumorsMelissa Bondy; Fiscal Year: 2004..Thus, patients who can tolerate higher doses of chemotherapy can be treated more efficiently, suffering from less side effects and potentially may have a better outcome. ..
- EFFECT OF COCAINE ON ENDOCRINE FUNCTION IN THE RATCatherine Rivier; Fiscal Year: 1992....
- An Assessment of a Problem Gambling Self-Change ToolkitRichard LaBrie; Fiscal Year: 2007..evaluation studies often places health care providers in the difficult position of deciding between withholding treatment or providing well-intentioned, but unproven treatment...
- Immune function in desensitized allograft recipientsJonathan Schneck; Fiscal Year: 2005....
- Retinoic Acid and Post-pneumonectomy Lung GrowthCONNIE HSIA; Fiscal Year: 2006..e., the consequences when a natural compensatory response is distorted by pharmacological manipulation that selectively alters some but not all aspects of the natural response. ..
- Antiretroviral-TIP for Substance UsersSarah Lewis; Fiscal Year: 2005..The reason most often cited by physicians for withholding treatment is active drug involvement...
- NOVEL NON-PEPTIDE ANTAGONIST OF THE MCH RECEPTORDavid Schwarz; Fiscal Year: 2003..Compounds successfully emerging from this process will be further evaluated in acute and chronic feeding paradigms in order to select candidates suitable for clinical trials. ..
- PHASE II CLINIAL TRIAL OF NEW CHEMOPREVENTIVE AGENTS - WOmer Kucuk; Fiscal Year: 2000..5) To evaluate the safety of zileuton in this cohort. ..
- Hospice Intervention for Older Adults With End Stage Renal DiseaseLewis Cohen; Fiscal Year: 2007..unreadable] [unreadable] [unreadable]..
- Improving Physician Skill at Providing End-of-Life CareJ Curtis; Fiscal Year: 2004..The results will allow investigators and others to develop targeted educational and systemic interventions to improve the quality of this care. ..
- Balancing Hope & Truth-Telling for Patients with Ca/COPDJ Curtis; Fiscal Year: 2005..These strategies will be described and translated into interventions targeting nurses, physicians, and teams who provide care for patients with cancer, COPD, and other life-limiting diseases. ..
- Patient-Centered Approach to Advance Care PlanningKARIN KIRCHHOFF; Fiscal Year: 2006..abstract_text> ..
- Family Experience: End of Life for a Family Member with a Chronic IllnessDEBRA LYNN MCHALE WIEGAND; Fiscal Year: 2009..The results of the study will be published and presented in local and national meetings to health care professionals and others who would benefit from information related to how to help these vulnerable family members. ..
- The impact of early antiretroviral therapy on HIV persistence and inflammationSTEVEN GRANT DEEKS; Fiscal Year: 2010..Our work may also provide important insights in the role of chronic inflammation in driving viral persistence, and hence may lead to the development of novel interventions. ..
- OUTCOME MEASURES FOR CLINICAL TRIALS IN STRABISMUSJonathan Holmes; Fiscal Year: 2008..Ultimately this research will result in better quality of life for patients with strabismus. ..
- Immunologic Control of Drug-resistant HIV-1Steven Deeks; Fiscal Year: 2005..Finally, since we will estimate the relative in vivo thresholds for HIV-mediated immunogenicity and pathogenicity, these studies may also have implications for vaccine development. ..
- Treatment Intensification for Drug-Resistant HIVSteven Deeks; Fiscal Year: 2004..Funding for the pilot clinical trial has been obtained from other sources; funding is requested in this proposal only for costs associated with the measurements of immunologic response to drug-resistant HIV-1. ..
- PATHOGENESIS OF RETINOPATHY OF PREMATURITYJonathan Holmes; Fiscal Year: 2003....
- DEVELOPMENTAL REGULATION OF O2 SENSING IN THE LUNGDavid Cornfield; Fiscal Year: 2009..The strategy of modulating BKCa channel subunit expression to enhance pulmonary vasodilation may be more broadly applicable to other vascular diseases. ..
- Fetal & Adolescent Nicotine Effects on CNS 5HT SystemsTheodore Slotkin; Fiscal Year: 2003..abstract_text> ..
- Maximizing CBT's Efficacy with Medication & CMKathleen Carroll; Fiscal Year: 2009..Variables assessing theoretical mechanisms of action will be assessed monthly during treatment. ..
- Predictors of Immunologic Long-term Non-Progression in Children with HIVJintanat Ananworanich; Fiscal Year: 2010..This will be important in deciding when to treat children with antiretroviral therapy. ..
- Familial Intracranial Aneurysm Study II (FIA II)JOSEPH PAUL BRODERICK; Fiscal Year: 2010..Finally, we will use bioinformatics, statistical methods, and gene sequencing, to identify specific disease producing mutations and/or high risk haplotypes whose functional relevance will be subsequently explored. ..
- Health Behavior Change in Cancer Patients and FamiliesCarolyn Rabin; Fiscal Year: 2003..This brief assessment study, therefore, has the potential to shed light on an important area of primary and secondary cancer prevention. ..
- Toward Optimal End-of-Life Care in the PICURobert Truog; Fiscal Year: 2010....
- PEDIATRIC AIDS CLINICAL TRIALS UNITWilliam Borkowsky; Fiscal Year: 2002..This effort will also be helped by established links to previously funded community resources, our community advisory board, and by our own local General Clinical Research Center. ..
- DRUGS AND DEVELOPMENT OF THE ADRENERGIC NERVOUS SYSTEMTheodore Slotkin; Fiscal Year: 2003....
- INTERACTIONS OF HIV-1GP120 WITH BRAIN CELLS: ROLE OF PAGAvindra Nath; Fiscal Year: 2001..The transfected cells will be screened for gp120 binding properties and for gp120-induced changes in intracellular calcium. The role of Pag in viral entry by itself or in conjunction with other HIV-coreceptors will also be determined. ..
- TREATMENT OF BEHAVIORAL SYMPTOMS IN ALZHEIMERS DISEASEDavangere Devanand; Fiscal Year: 2001..These clinical data will be important in improving the management of AD patients with behavioral complications. ..
- TREATMENT OF NEGATIVE SYMPTOMS & COGNITIVE IMPAIRMENTSWilliam Carpenter; Fiscal Year: 2003..The study will provide new information on the efficacy of d- cyclosporine and glycine for both persistent primary and secondary negative symptoms and its effect on cognitive functioning. ..
- Feasibility and Pilot Efficacy of Flash-heated Breastmilk to Reduce Pediatric HIVCaroline Chantry; Fiscal Year: 2008..unreadable] [unreadable] [unreadable]..
- MECHANISMS OF CHLORPYRIFOS DEVELOPMENTAL NEUROTOXICITYTheodore Slotkin; Fiscal Year: 2004..Molecular mechanisms of developmental neurotoxicity can be determined and linked to eventual alterations in behavioral performance. ..
- EDUCATIONAL RESOURCE FOR TUMOR HETEROGENEITYRoger Day; Fiscal Year: 2004..Utilization of the Patient Encounter Interface in an ongoing training program for oncology residents, focused on patient management skills. ..
- PROSPECTIVE INVESTIGATION OF PULMONARY EMBOLISM DX-IIPaul Stein; Fiscal Year: 2003..4) The team of investigators is strong, and has collaborated previously in successful research in PE. ..
- Inflammation and Immunity in Dilated CardiomyopathyLeslie Cooper; Fiscal Year: 2004..The long-term overall goal of this workshop is to translate advances in molecular and cellular mechanisms of disease into improvements in the diagnosis and treatment of patients with DCM. ..
- NEUROLEPTIC-INDUCED MOVEMENT DISORDERS IN OLDER PATIENTSDilip Jeste; Fiscal Year: 2003..We believe that our findings will have major therapeutic implications for the use of antipsychotics, particularly in older patients. ..
- COMMUNITY CONTEXT, SEP OPERATIONS, & HIV RISK AMONG IDUsRicky Bluthenthal; Fiscal Year: 2005..abstract_text> ..
- End of Life Communication Skills for Oncology FellowsAnthony Back; Fiscal Year: 2005..This program will create a formal curriculum for communication skills that could be replicated in many institutions to improve the quality of oncologists-patient communication--and ultimately the quality of cancer care--nationwide. ..
- SOCIAL AND ENVIRONMENTAL CONTEXTS OF ADAPTATIONPETER DITTO; Fiscal Year: 2006..We request funding to support three (3) predoctoral and three (3) postdoctoral trainees in the next project period. ..
- PST in Geriatric Depression with Executive DysfunctionPatricia Arean; Fiscal Year: 2006..Accordingly, we are well positioned to meet the challenges inherent in this difficult but important area of research. ..
- ACTION - A CHF Trial Investigating Outcomes of ExerciseGregg Fonarow; Fiscal Year: 2006..The trial will take place over 5 years with an initial 6 months for planning, training, and implementation; 3 years of enrollment; 1 year of follow-up; and 6 months for close out, analysis, and presentation. ..
- Functional Mechanisms of Antibody Inhibition of HIV-1Marshall Posner; Fiscal Year: 2008..Long-term objectives will be to select constructs from in vitro testing for further testing in non-human primate models of prevention and therapeutics. ..
- fMRI Predictor Model for Stroke Locomotor RehabilitationBruce Dobkin; Fiscal Year: 2008..The study is a step toward using fMRI as a tool to develop theory- and evidencebased practices that lessen disabilities after stroke. [unreadable] [unreadable] [unreadable]..
- ICU CULTURE AND PROBLEMATIC TREATMENT LIMITATION CASESJUDITH BAGGS; Fiscal Year: 2002..With a description of such barriers and facilitators, it will be possible to design interventions to serve patients' interests and be mutually acceptable to patients, families, and health care providers. ..
- Improving memory after hippocampal cell lossMARK BARDGETT; Fiscal Year: 2007..The results may shed light on new directions in the treatment of memory disorders, and the proposed work will also enhance education in biomedical research among college undergraduates in Kentucky. [unreadable] [unreadable] [unreadable]..
- Preschool Vision Screening in Primary Care SettingsAlex Kemper; Fiscal Year: 2007....
- Risk and Predictors of Postpartum DepressionLee Cohen; Fiscal Year: 2007..AItshuler, Dr. Hendrick), and the Emory Women's Mental Health Program at Emory University School of Medicine (Dr. Stowe). [unreadable] [unreadable]..
- The Obese Critical III: Process and Outcome DisparitiesJames O Brien; Fiscal Year: 2008..These studies will describe the effect of excess body weight on critical illness and produce a new type of independent investigator - the ICU health services researcher. ..
- MECHANISMS OF CUTANEOUS INJURY IN LUPUS ERYTHEMATOSUSRichard Sontheimer; Fiscal Year: 2001....
- Mechanisms of Innate and Adaptive Immunity In HCVDavid Nelson; Fiscal Year: 2009..A better understanding of the immunologic factors that determine resolution or persistence of the infection may help in the design of therapies and vaccines for the control of HCV infection. ..