Article
Pediatrics
R. Cremer, L. de Saint Blanquat, S. Birsan, F. Bordet, A. Botte, O. Brissaud, J. Guilbert, B. Le Roux, C. Le Reun, F. Michel, F. Millasseau, M. Sinet, P. Hubert
Summary: This article summarizes the recommendations issued by the French-speaking task force on pediatric critical and emergency care regarding withholding and withdrawing treatments in pediatric critical care. It aims to assist pediatric critical care teams in finding a compromise between ethical principles and compliance with regulations and laws.
ARCHIVES DE PEDIATRIE
(2021)
Review
Critical Care Medicine
Emily K. Rose, James O'Connor
Summary: COPD is a progressive disease that affects patients' quality of life, and it is crucial to discuss patients' care goals before the disease becomes refractory. Advance Care Planning (ACP) is a comprehensive approach to discussing goals with patients. Existing research has shown that ACP improves communication, reduces hospital admissions, and enhances quality of life, although most studies have focused on cancer patients. Without further research and guidance, obtaining funding for ACP programs dedicated to COPD may be challenging. There are currently no guidelines for addressing ACP in patients with COPD, and barriers exist that hinder meaningful discussions between patients, families, and healthcare providers. Research has also indicated that multidisciplinary teams can improve care and quality of life. Therefore, dedicated research should investigate the effects of ACP initiatives on outcomes in COPD patients, particularly in reducing hospital admissions and improving quality of life.
Article
Clinical Neurology
Jenny T. van der Steen, Miharu Nakanishi, Lieve van den Block, Paola Di Giulio, Silvia Gonella, Juergen In Der Schmitten, Rebecca L. Sudore, Karen Harrison Dening, Deborah Parker, Ninoslav Mimica, Iva Holmerova, Philip Larkin, Sandra Martins Pereira, Judith A. C. Rietjens, Ida J. Korfage
Summary: This study aimed to conceptualize advance care planning for dementia through a Delphi study, focusing on defining the concept and identifying key issues such as capacity, family, and engagement. The results highlighted the importance of communication and relationship-centered approach for ACP in dementia.
ALZHEIMERS & DEMENTIA
(2023)
Review
Oncology
Adela Wu, Gabriela Ruiz Colon, Rebecca Aslakson, Erqi Pollom, Chirag B. Patel
Summary: Glioblastoma is the most common primary brain malignancy in adults, with a devastating prognosis despite standard treatments. Advance care planning and palliative care are critical for these patients, yet many do not pursue it or have access to these services. More focused and high-quality studies on end-of-life care are needed to address gaps in palliative care resource utilization for glioblastoma patients.
Article
Oncology
Michael G. Cohen, Andrew D. Althouse, Robert M. Arnold, Hailey W. Bulls, Douglas B. White, Edward Chu, Margaret Q. Rosenzweig, Kenneth J. Smith, Yael Schenker
Summary: This study found that engagement in advance care planning (ACP) did not decrease hope in patients with advanced cancer, and may even increase hope. These results may provide reassurance to clinicians who are apprehensive about having these important and difficult conversations.
Review
Pediatrics
Nadine Lusney, Camara van Breemen, Edlyn Lim, Colleen Pawliuk, Zahra Hussein
Summary: To assess pediatric advance care planning (pACP) documentation and implementation, clinicians at a Canadian pediatric hospice conducted a scoping review. Sixty-four articles and fifteen pACP forms/tools were reviewed, highlighting the importance of a structured, collaborative, and iterative process between families and healthcare providers. No single ACP tool was identified as the gold standard, and implementation strategies included a structured pACP tool, ongoing training, mentorship, and organizational structures.
Article
Ethics
James Cameron, Julian Savulescu, Dominic Wilkinson
Summary: The COVID-19 pandemic has raised concerns about ventilator shortages and sparked debates about the ethics of withdrawing treatment from one patient to provide it to another. Inconsistent advice to doctors on this issue may lead to underutilization of available resources and negative consequences. A national policy is urgently needed to guide doctors in prioritizing patients and maximizing benefits from limited resources.
JOURNAL OF MEDICAL ETHICS
(2021)
Review
Nursing
Hyejin Kim, Jeonghyun Cho, Won Seok Park, Sang Suk Kim
Summary: The study aimed to compare characteristics of ACP interventions across dementia stages, finding major differences in intervention recipients between mild and advanced dementia stages. Most interventions included structured discussions on life goals, values, care preferences, but lacked designs to promote ongoing discussions and documentation. Nurses played important roles in implementing ACP interventions.
JOURNAL OF NURSING SCHOLARSHIP
(2021)
Review
Health Care Sciences & Services
Karen Carr, Felicity Hasson, Sonja McIlfatrick, Julia Downing
Summary: Factors influencing healthcare professionals' decision to initiate pediatric advance care planning include uncertainty regarding prognosis, responsibility, and unpredictable parental reactions. More research is needed to support healthcare professionals in these conversations.
PALLIATIVE MEDICINE
(2021)
Review
Nursing
Marie Cerulus, Inge Bossuyt, Birgit Vanderhaeghen
Summary: The study conducted an integrative literature review on action research in the implementation of advance care planning in a hospital setting. It was found that interventions focusing on identifying at-risk patients, adapting documentation and using communication improvement tools can enhance the effectiveness of advance care planning implementation.
JOURNAL OF CLINICAL NURSING
(2021)
Article
Nursing
Hye Ri Choi, Sheila Rodgers, Jennifer Tocher, Sung Wook Kang
Summary: This study explores the experiences of nurses, physicians, and family members in South Korea's intensive care unit regarding the withholding or withdrawing of life-sustaining treatment. The research reveals that family members have the strongest influence in the treatment process, although it must be based on medical considerations. All participants in the study agreed that the purpose and motivation for withholding or withdrawing life-sustaining treatment are to maintain the dying patient's dignity. The findings also highlight the impact of South Korea's cultural context and healthcare system on the decision-making process and relationships between medical staff and family members.
JOURNAL OF CLINICAL NURSING
(2023)
Article
Nursing
Anne Kuusisto, Jenni Santavirta, Kaija Saranto, Elina Haavisto
Summary: The study aimed to explore healthcare professionals' perceptions of advance care planning (ACP) in a palliative care unit. Findings showed that the information content of ACP, coordination of care activities through ACP, and support for patients' and family members' coping were key themes. ACP was seen as a proactive tool for integrating patient-centric information and services, as well as supporting coping mechanisms.
JOURNAL OF CLINICAL NURSING
(2021)
Article
Medicine, General & Internal
Jung Eun Kwon, Yeo Hyang Kim
Summary: This study examined the changes in end-of-life processes for pediatric patients with life-limiting conditions before and after pediatric palliative care (PPC) intervention. The analysis of medical records showed that there were more discussions on advanced care planning and treatment choices in the PPC group. The frequency of intubation and CPR decreased, and there were more home deaths in the PPC group. The survey also revealed high satisfaction with emotional support, practical assistance, and symptom management.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Pediatrics
Karen Carr, Felicity Hasson, Sonja McIlfatrick, Julia Downing
Summary: Parents expressed the need for a trusted professional and time for private, thorough, non-judgemental discussions when initiating advance care planning for their children. They also highlighted the importance of health professionals understanding and supporting them during this process.
EUROPEAN JOURNAL OF PEDIATRICS
(2022)
Article
Medicine, General & Internal
Laura Panozzo, Zakary Doherty, Michael Leach, Bernadette Ward
Summary: A cross-sectional study of 123 Victorian hospitals between July 2016 and December 2018 determined the prevalence and factors associated with advance care planning (ACP) documents for Australian public hospital inpatients. Of the 611,786 included patients, 2.9% had an ACP document. Odds increased significantly in those comorbid, unpartnered, regional and >5 admissions, which supports future ACP conversations and document creation.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Pediatrics
Patricia Reparaz, Idoya Serrano, Rosa Adan-Pedroso, Itziar Astigarraga, Jimena de Pedro Olabarri, Aizpea Echebarria-Barona, Miguel Garcia-Ariza, Ricardo Lopez-Almaraz, Rafael Andres del Orbe-Barreto, Miriam Vara-Pampliega, Paula Gonzalez-Urdiales
Summary: Hospital admissions for acute complications are common in patients with sickle cell disease, with vaso-occlusive crisis and febrile syndrome being the most frequent. These patients require a high use of antibiotics and opioid analgesia. Early diagnosis facilitates the recognition of life-threatening complications.
ANALES DE PEDIATRIA
(2022)
Article
Pediatrics
Itziar Astigarraga, Susana Garcia-Obregon, Antonio Perez-Martinez, Ignacio Gutierrez-Carrasco, Vicente Santa-Maria, Carmen Rodriguez-Vigil Iturrate, Mikael Lorite Reggiori, Thais Murciano Carrillo, Montse Torrent
Summary: Langerhans cell histiocytosis (LCH) is a myeloid neoplasia that requires complex diagnosis and treatment. Molecular testing and clinical assessments are essential in determining the extent of the disease and treatment options.
ANALES DE PEDIATRIA
(2022)
Article
Pediatrics
Cinta Moraleda, Sara Dominguez-Rodriguez, Juan Miguel Mesa, Paula Garcia-Sanchez, Maria de la Serna, Jose Antonio Alonso-Cadenas, Amanda Bermejo, Gema Sabrido, Leticia Martinez-Campos, Aranzazu Flavia Gonzalez-Posada, Marta Illan-Ramos, Elena Cobos-Carrascosa, Alvaro Ballesteros, Juan Carlos Galan, Francisco Llorente, David Aguilera-Alonso, Ana Belen Jimenez, Pilar Catalan, Elias Dahdouh, Ignacio Navarro, Barbara Fernandez-Garoz, Pablo Mendoza, Concepcion Perez-Jorge, Teresa Cabezas-Fernandez, Daniel Blazquez-Gamero, Gonzalo Rivas, Patricia Gonzalez-Donapetry, Elena Saez, Jovita Fernandez-Pinero, Jesus Lucas-Fernandez, Elisa Perez-Ramirez, Paloma Merino, Sandra Miragaya, Jorge Lorente, Irene Iglesias, Alfredo Tagarro
Summary: This study evaluated the performance of oral saliva swab (OSS) reverse transcription PCR (RT-PCR) compared with RT-PCR and antigen rapid diagnostic test (Ag-RDT) on nasopharyngeal swabs (NPS) for SARS-CoV-2 in children. The results showed that RT-PCR on the OSS sample is an accurate option for SARS-CoV-2 testing in children, providing a less invasive alternative for younger patients.
ARCHIVES OF DISEASE IN CHILDHOOD
(2022)
Article
Medicine, General & Internal
Jaime Gallego Perez-Larraya, Marc Garcia-Moure, Sara Labiano, Ana Patino-Garcia, Jessica Dobbs, Marisol Gonzalez-Huarriz, Marta Zalacain, Lucia Marrodan, Naiara Martinez-Velez, Montserrat Puigdelloses, Virginia Laspidea, Itziar Astigarraga, Blanca Lopez-Ibor, Ofelia Cruz, Miren Oscoz Lizarbe, Sandra Hervas-Stubbs, Gorka Alkorta-Aranburu, Ibon Tamayo, Beatriz Tavira, Ruben Hernandez-Alcoceba, Chris Jones, Gitanjali Dharmadhikari, Cristian Ruiz-Moreno, Henk Stunnenberg, Esther Hulleman, Jasper van der Lugt, Miguel A. Idoate, Ricardo Diez-Valle, Ines Esparragosa Vazquez, Maria Villalba, Carlos de Andrea, Jorge M. Nunez-Cordoba, Brett Ewald, Joan Robbins, Juan Fueyo, Candelaria Gomez-Manzano, Frederick F. Lang, Sonia Tejada, Marta M. Alonso
Summary: This study investigated the use of oncolytic virus DNX-2401 in pediatric patients with diffuse intrinsic pontine glioma (DIPG). The results showed that treatment with DNX-2401 led to changes in T-cell activity and reduction or stabilization of tumor size in some patients, but also caused adverse events.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Oncology
Julia Salmeron-Villalobos, Joan Enric Ramis-Zaldivar, Olga Balague, Jaime Verdu-Amoros, Veronica Celis, Constantino Sabado, Marta Garrido, Sara Mato, Javier Uriz, M. Jose Ortega, Angela Gutierrez-Camino, Daniel Sinnett, Unai Illarregi, Maxime Carron, Alexandra Regueiro, Ana Galera, Blanca Gonzalez-Farre, Elias Campo, Noelia Garcia, Dolors Colomer, Itziar Astigarraga, Mara Andres, Margarita Llavador, Idoia Martin-Guerrero, Itziar Salaverria
Summary: This study characterized the genetic and molecular heterogeneity of pediatric T-LBL and identified novel molecular markers differentiating it from T-ALL. It found recurrent genetic alterations in pediatric T-LBL, including homozygous deletions of CDKN2A, trisomy 20, and gains of 17q24-q25. The study also revealed novel gene fusions and highlighted the association of Notch pathway alterations with a favorable prognosis in pediatric T-LBL.
PEDIATRIC BLOOD & CANCER
(2022)
Review
Oncology
Piedad Alba-Pavon, Lide Alana, Itziar Astigarraga, Olatz Villate
Summary: Recent studies suggest that at least 10% of pediatric cancer patients carry a germline mutation in a cancer predisposition gene. Splicing mutations play a significant role in the development of pediatric solid tumors, and therapies to correct aberrant splicing in cancer have been developed.
Article
Multidisciplinary Sciences
Piedad Alba-Pavon, Lide Alana, Miriam Gutierrez-Jimeno, Susana Garcia-Obregon, Teresa Imizcoz, Elena Panizo, Paula Gonzalez-Urdiales, Aizpea Echebarria-Barona, Ricardo Lopez Almaraz, Laura Zaldumbide, Itziar Astigarraga, Ana Patino-Garcia, Olatz Villate
Summary: Genetic predisposition plays a significant role in pediatric cancer, but the relationship between individual genetic mutations and childhood cancer is still being investigated. Sarcomas are often associated with cancer predisposition syndromes, but this is frequently overlooked due to the rarity and heterogeneity of sarcomas and limited search for genetic syndromes. This study identified potential pathogenic germline variants in several genes associated with cancer predisposition syndromes in pediatric sarcoma patients through tumor profiling and sequencing analysis. The results indicate that somatic testing can help identify individuals at risk of underlying cancer predisposition syndromes.
SCIENTIFIC REPORTS
(2023)
Meeting Abstract
Oncology
Idoya Serrano Pejenaute, Ricardo Lopez-Almaraz, Aizpea Echebarria, Rosa Adan, Jimena De Pedro, Paula Gonzalez, Jesus Sanchez, Julio Lopez-Bayon, Itziar Astigarraga, Miguel Garcia-Ariza