Literature Review

Trends in hepatocellular carcinoma mortality rates in the US and projections through 2040JAMA Network Open; Sikai Qiu, MM; Jiangying Cai, MM; Zhanpeng Yang, MM; Xinyuan He, MD; Zixuan Xing, MD; Jian Zu, PhD; Enrui Xie, MD; Linda Henry, MD; Custis R. Chong, MD; Esther M. John, MD; Ramsey Cheung, MD; Fanpu Ji, MD, PhD; Mindie H. Nguyen, MD, MAS; 11/24Primary liver cancer imposes a substantial global disease burden, ranking as the sixth most commonly diagnosed cancer worldwide and the third-leading cause of global cancer-related mortality in 2020. In this cross-sectional study of 188,280 HCC [hepatocellular carcinoma]-related deaths, ASMRs [age-standardized mortality rates] increased from 2006 to 2022 and were projected to continue rising until 2040, primarily due to increased deaths from alcohol-associated liver disease (ALD) and metabolic dysfunction–associated steatotic liver disease (MASLD); deaths from viral hepatitis were under control and were projected to decrease. Large disparities were observed in HCC-related ASMRs by age, sex, and race and ethnicity. ...these findings may serve as a reference for public health decision-making and timely identification of groups at high risk of HCC-related death.

Palliative care bypasses Black heart disease patients The St. Louis American; by Alvin A. Reid; 11/30/24 A study by Saint Louis University researchers paints a grim picture for many heart failure patients in America – and the outlook is worse for African Americans. The study, published in the Journal of the American Heart Association, found that only one in eight patients with heart failure nationwide receive palliative care consultations within five years of diagnosis. Alarmingly, Black people were 15% less likely to receive palliative care compared to white patients with similar heart health illness. Other recent respective studies illustrate the higher risk and mortality rates for cardiovascular disease in the Black population – further demonstrating that the missing palliative care options have a greater negative impact on African American health. New statistics from a medical team at EHproject show African American women are at a greater risk for cardiovascular disease than their white counterparts. It found that 47.3% of Black women have heart disease. If they do not have it currently, they are 2.4 times more likely to develop heart disease. ... A March 2023 study published in JAMA Cardiology showed that Black men remain at the highest risk of dying from cardiovascular disease. ... 

[Netherlands] Electronic health in the palliative care pathway for patients with head and neck cancerJAMA Otolaryngology- Head & Neck Surgery; Boyd N. van den Besselaar, MD; Kira S. van Hof, MD; Aniel Sewnaik, PhD; Robert. J. Baatenburg de Jong, PhD; Marinella P. J. Offerman, PhD; 11/24Head and neck cancer (HNC) generally has a poor prognosis, with more than 40% disease-specific mortality, ... with a median survival of 4 to 5 months. Given the unique nature of HNC, with a wide range of specific cancer-related symptoms, special consideration should be given to end-of-life care. In this quality improvement study, patients and next of kin were satisfied with most aspects of the hybrid palliative care pathway, and remote care seemed to be a promising means of delivery. These insights represent the initial steps toward gaining a deeper understanding of patients’ needs during specific moments in a hybrid palliative trajectory. They may support health care professionals in optimizing personalized and value-based palliative care delivery.

Guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults-A WikiGuidelines group consensus statementJAMA Network Open; Zachary Nelson, PharmD, MPH; Abdullah Tarık Aslan, MD; Nathan P. Beahm, PharmD; Michelle Blyth, MD, MSPH; Matthew Cappiello, MD; Danielle Casaus, PharmD; Fernando Dominguez, MD; Susan Egbert, PharmD; Alexandra Hanretty, PharmD; Tina Khadem, PharmD; Katie Olney, PharmD; Ahmed Abdul-Azim, MD; Gloria Aggrey, MD; Daniel T. Anderson, PharmD; Mariana Barosa, MD, MSc; Michael Bosco, PharmD; Elias B. Chahine, PharmD; Souradeep Chowdhury, MBBS; Alyssa Christensen, PharmD; Daniela de Lima Corvino, MD; Margaret Fitzpatrick, MD, MS; Molly Fleece, MD; Brent Footer, PharmD; Emily Fox, PharmD; Bassam Ghanem, PharmD, MS; Fergus Hamilton, MRCP, PhD; Justin Hayes, MD, MPH; Boris Jegorovic, MD, PhD; Philipp Jent, MD; Rodolfo Norberto Jimenez-Juarez, MD; Annie Joseph, MBBS; Minji Kang, MD; Geena Kludjian, PharmD; Sarah Kurz, MD; Rachael A. Lee, MD, MSPH; Todd C. Lee, MD, MPH; Timothy Li, MBChB; Alberto Enrico Maraolo, MD, MSc; Mira Maximos, PharmD, MSc, ACPR; Emily G. McDonald, MD, MSc; Dhara Mehta, PharmD; Justin William Moore, PharmD, MS; Cynthia T. Nguyen, PharmD; Cihan Papan, MD; Akshatha Ravindra, MD; Brad Spellberg, MD; Robert Taylor, PhD; Alexis Thumann, PharmD; Steven Y. C. Tong, MBBS (Hons), PhD; Michael Veve, PharmD, MPH; James Wilson, DO; Arsheena Yassin, PharmD; Veronica Zafonte, PharmD; Alfredo J. Mena Lora, MD; 11/24Urinary tract infections (UTIs) are among the most common infections globally, notably impacting patient quality of life and posing substantial clinical and economic challenges. In this third WikiGuidelines consensus statement, we provide an evidence-based approach to UTI management developed by a global network of experts for practical use across diverse clinical settings. This guideline fills a critical gap by providing pragmatic, broadly applicable recommendations tailored for generalist care and systems-based practice. Our guidance is rooted in the best available evidence and is designed for clinicians from various backgrounds and health care environments. It emphasizes a patient-centered approach to the diagnosis, prevention and treatment of UTIs and related genitourinary infections.

Education, telehealth, and access initiatives aim to improve cancer care for veteransOncLive; by Kyle Doherty; 11/26/24 Manali I. Patel, MD, MPH, MS, details several interventions developed to better serve veterans with cancer who are experiencing economic, social, and geographic barriers to care. Despite having the option of cancer care through the Veterans Affairs (VA) health network, veterans with cancer still experience economic, social, and geographic barriers to receiving high-quality care. This has prompted investigators to develop several interventions to better serve these patients. “Veterans have higher rates of lung cancer [compared with] civilian populations; prostate and bladder cancer [rates] are also pronounced [among] veterans, [and we also see] higher rates of melanoma, [all] largely due to exogenous exposure risk,” Manali I. Patel, MD, MPH, MS, said in an interview with Oncology Live. “One of the biggest barriers [to cancer care] for veterans is the lack of system level resources that can ensure veterans understand the diagnosis and treatment options, such that veterans receive care that is concordant with their goals, preferences, and values. Cancer care is quite complex and trying to not only coordinate care but explain the nuances in plain language is challenging. Having resources [available] that proactively assist veterans in their understanding and support them through cancer care is what is most needed to improve patient outcomes.”

Dialysis facility staffing ratios and kidney transplant access among adolescents and young adultsJAMA; Alexandra C. Bicki, MD, MPH; Barbara Grimes, PhD; Charles E. McCulloch, PhD; Timothy P. Copeland, MPP, PhD; Elaine Ku, MD, MAS; 10/24In this study of adolescents and young adults treated at US dialysis facilities, patients at facilities with higher patient to staff ratios had lower incidence of waitlisting and kidney transplant compared with those receiving care at facilities with lower patient to staff ratios. The effect size for the incidence of transplant was similar with respect to both patient to nurse and patient to social worker staffing ratios, but patient to nurse ratio was not statistically significantly associated with the incidence of waitlisting.

[Australia] Components of home-based palliative and supportive care for adults with heart failure: A scoping reviewPalliative Medicine; Madhurangi Perera, Ureni Halahakone, Sameera Senanayake, Sanjeewa Kularatna, William Parsonage, Patsy Yates, Gursharan K. Singh; 10/24Palliative care and supportive care provided in the home for people with heart failure can improve quality of life, caregiver wellbeing and reduce healthcare costs. Ensuring patient and caregiver-centred care supported by a multidisciplinary team is essential to delivering home-based palliative and supportive care for people with heart failure. Further research focussed on the role of digital interventions in home-based palliative and supportive care, the composition of the multidisciplinary team and research which includes individuals across all stages of heart failure is needed.

Walking pneumonia is booming − and targeting the young and the poor USA Today, Arlington, VA; by John Bacon; 11/20/24 Infections of the bacteria that cause walking pneumonia, a lesser evil of the more serious illness of pneumonia, is seeing a dramatic jump after a lengthy decline that came with the start of the COVID-19 pandemic, health officials say. Most alarming is the sharp increase in children infected with the disease. And, as with COVID-19, the impact of the disease can hit low-income Americans the hardest. The Centers for Disease Control and Prevention said infections from the bacteria that can cause walking pneumonia are common: An estimated 2 million infections occur each year in the United States. However, the true number isn't known, in part because so many people get it without seeking medical help and in part because there is no nationwide reporting system. The infections dropped off during the COVID pandemic but are now booming. Hospital emergency department discharge data from April to October showed an increase in infections of the bacteria among all age groups, according to the CDC.

'Art helps me deal with my cancer diagnosis' BBC News, West Midlands, United Kingdom; by Sophie Madden; 11/18/24 After being diagnosed with pancreatic cancer, Wendy Brookfield said she had lots of emotions. But a referral to art therapy through the Severn Hospice, based in Shrewsbury, Shropshire, helped her deal with what she was going through. "There is so much going on in your mind that being able to go along to art therapy, I could just get it out and get it down on paper," she said. "It just such a good outlet for me." Her therapy sessions led to her starting a book of sketches which she regularly filled in, sometimes during her treatment sessions. They inspired the hospice to host its own art exhibition, built around Ms Brookfield's work and with other pieces created by patients. 

Comorbid depression in patients with head and neck cancer compared with other cancersJAMA Otolaryngology-Head Neck Surgery; Marina C. Martinez,; Andrey Finegersh, MD, PhD; Fred M. Baik, MD; F. Chris Holsinger, MD; Heather M. Starmer, PhD, CCC-SLP, BCS-S; Lisa A. Orloff, MD; John B. Sunwoo, MD; Davud Sirjani, MD; Vasu Divi, MD; Michelle M. Chen, MD, MHS; 10/24This cohort study found that patients with HNC were twice as likely to screen positive for depression on a validated survey than those with other cancers, despite having similar rates of self-reported depression and depression medication use. These findings suggest that self-reporting of depression may result in underreporting and undertreatment in this population and, thus, a need for further work in developing interventions to improve identification of and optimize treatment for patients with HNC and comorbid depression.

Timing of palliative care, end-of-life quality indicators, and health resource utilizationJAMA Network Open; Sarah J. Mah, MD, MSc; Daniel M. Carter Ramirez, MD, PhD; Kara Schnarr, MD, PhD; Lua R. Eiriksson, MD, MPH; Anastasia Gayowsky, MSc; Hsien Seow, PhD; 10/24In this cohort study of 8,297 individuals with ovarian cancer decedents, initiating palliative care earlier than 3 months before death was associated with lower rates of death in the hospital, late chemotherapy, intensive care unit admission, and aggressive care at the end-of-life. Implementation strategies for early palliative care initiation are needed to optimize care quality and health resource utilization at the end of life.

Signs and symptoms of end-of-life kidney failure Health; by Lindsay Curtis; 11/8/24 Kidney failure, or end-stage kidney disease (ESKD), occurs when the kidneys lose their ability to filter waste and excess fluids from the blood. As toxins and fluid build up in the body, other health problems can develop, increasing the risk of life-threatening complications. ...