Other interventions may include special forms of physical therapy to strengthen weakened respiratory muscles, as well as aggressive management of infections. Physical therapy has an important role to prevent contractures and deformity. As growth failure and feeding difficulties are common in children with PD, nutritional intervention is required. Recently videofluoroscopic study of swallowing demonstrated that pediatric PD patients show oropharyngeal dysphagia with airway invasion and poor cough reflex. Videofluoroscopic assessment of dysphagia should be recommended in PD pediatric patients to establish Inhibitors,research,lifescience,medical the need for supportive treatment. Similarly hearing

loss is now increasingly recognized in classic infantile patients and periodical hearing assessment should be performed. In conclusion multidisciplinary follow-up, coordinated by a metabolic pediatrician or a pediatric Inhibitors,research,lifescience,medical neurologist, is needed in PD patients for early identification and supportive treatment of multi-organ complications.

No curative treatment is available for the two dystrophinopathies, Inhibitors,research,lifescience,medical Becker and Duchenne muscular dystrophies. In 1995, low-dose steroid treatment was shown to diminish deterioration of muscle strength in Duchenne muscular dystrophy (1), and is now routinely

offered to many, preferentially ambulatory, patients. Symptomatic treatment such as ventilatory support and physiotherapy has also led to improvements of life quality and survival. In spite of this progress, Inhibitors,research,lifescience,medical however, the dystrophinopathies progress relentlessly

and typically result in severe disability. A promising new treatment is exon-skipping therapy which is based on converting an “out-of-frame” mutation into an “in-frame” mutation, and thus transforming a severe Duchenne phenotype to a mild Becker phenotype. Phase 1-2 trials are ongoing to investigate the feasibility of exon skipping for Duchenne (2, 3). With the possible introduction of exon skipping therapy, Inhibitors,research,lifescience,medical it has become increasingly important to know the exact role of each exon of the dystrophin gene on protein expression, and thus the phenotype. In this report, we present two related men with an unusually mild Becker muscular dystrophy phenotype associated with a novel exon 26 deletion. Methods After informed consent, we studied the phenotype of the index person and his maternal uncle. The disease history was obtained in a formal interview Ketanserin and clinical examination was carried out with estimation of muscle strength and evaluation of muscle bulk. Needle biopsies were performed in the lateral vastus muscle. Multiplex western blots were performed as described by Anderson (4). An electrocardiogram and echocardiography were performed in both patients. Results The proband, a mTOR inhibitor 23-year-old man, had slightly delayed motor milestones, walking 1½ years old.

The complications of anticancer drugs have caused scientists to try two approaches to solve the problem: developing new drugs with fewer side effects and application of new drug delivery systems with high specificity to cancerous tissues; the second approach has lower costs and more attention nowadays. Solid lipid nanoparticles

(SLNs) are one of the most important nanosized drug delivery systems that were introduced about two decades ago [4]. SLNs Inhibitors,research,lifescience,medical that are often considered for intravenous application are colloidal submicron carriers sized 50 to 1000nm and composed of solid lipids dispersed in water or surfactant aqueous solution. These nanoparticles have particular features like small size, high surface area, and high loading of drug that makes them potent and beneficial carriers for improving drug efficacy [5, 6]. SLNs are similar to o/w emulsions used for total parenteral

nutrition; the difference is that emulsion liquid lipid has been replaced with a solid lipid. SLNs have advantages such as controlled drug release in considered Inhibitors,research,lifescience,medical site, excellent biocompatibility, increase in drug stability, high drug content, easy industrialization Inhibitors,research,lifescience,medical and sterilization, better control of drug release kinetics, high bioavailability for bioactive drugs, chemical protection of sensitive drugs, easier producing rather than biopolymeric nanoparticles, producible by common emulsification methods, long-time stability, and various applications [4, 7, 8]. For parenteral administration, SLN dispersions must be sterile. SLNs with appropriately small particle size less than 200nm can be sterilized using filtration. Inhibitors,research,lifescience,medical Autoclaving the finished dispersion is not Tasocitinib solubility dmso practical as the lipids melt at sterilizing temperatures and the molten lipid droplets coalesce. Therefore just aseptic manufacturing processes following sterilization of the starting materials by gamma irradiation of the Inhibitors,research,lifescience,medical final dispersion or exposure to ethylene oxide (EO) gas are applicable for their sterilization. Bacterial endotoxins in raw materials need to be monitored, especially when raw materials

are of natural origin. It may be possible to lyophilize the SLN dispersions, and this lyophile Tolmetin can be irradiated or exposed to EO. SLNs are used in transdermal applications, as gene vector carriers, for topical uses, as cosmeceuticals, as targeted carriers of anticancer drugs to solid tumors, in breast cancer and lymph node metastases and in antitubercular chemotherapy. So far successful studies have been performed upon nanoparticles containing etoposide. For example, the study of Yadav et al. [9] was performed in the survey of poly(lactic-coglycolic acid)-monomethoxy-poly(polyethylene glycol) and poly(lactic-coglycolic acid)-Pluronic block copolymers and the study of Reddy et al. [10] on nanoparticles produced by tripalmitin could be mentioned.

As would be the case

for Kraepelin later, many cases that captured the interest of both Esquirol and Prichard had forensic consequences. This shows that the practical question was whether psychiatry could explain patterns of abnormal behavior, in subjects with a normal intellect and no acute psychiatric symptoms who had come into contact with the law. The period between the late 19th century and early 20th century was marked by the emergence of several elaborate systems of normal and abnormal personality, associating to Inhibitors,research,lifescience,medical some degree types and dimensions. A succession of European psychologists, such as Ribot, Heymans, and Lazursky, deserve mention. Theodule Ribot (1839-1916), a French psychologist known for coining the term “Anhedonia,” wrote on normal and abnormal characters.11 Ribot’s treatise was translated into English within a year (the Psychology of Emotions, 1897), and English-speaking contemporaries were familiar with his ideas. Like his predecessors, Ribot stressed that character is stable, appearing in childhood and lasting all life. Ribot’s Inhibitors,research,lifescience,medical classification had ”subtypes,“ defined by the association of several ”primary types.“ Ribot’s terminology

is antiquated, but Inhibitors,research,lifescience,medical his system becomes more limpid when one realizes that he is, in fact, describing dimensions. Normal personality was characterized by the three following primary types: (i) the sensitive or emotional, whose nervous system was easily impressed by pleasant or unpleasant emotions, and whose feelings were introverted; (ii) the active, who were extraverted, spontaneous, and courageous; (iii) and the apathetic, corresponding to the lymphatic of the humoral classification, who displayed little Inhibitors,research,lifescience,medical propensity to excitation and reaction. These three primary categories were further subdivided into various ”subtypes,“ according to the association of several dimensions. For instance, the sensitive were subdivided into: the (i) humble, with limited

intelligence and energy; (ii) the contemplative, who showed sensitivity, a keen intellect, and little activity Inhibitors,research,lifescience,medical (Hamlet, indecisive, was given as an example); and (iii) the emotional, stricto sensu. Among the active, the association of high activity, high intelligence, and little sensitivity Adenylyl cyclase could produce historical figures such as empire builders (Ribot mentioned Hernan Cortez and Pizarro). Subjects associating Fostamatinib supplier apathy with intelligence were good at strategy and unemotional reasoning (eg, Benjamin Franklin, or Philip II of Spain). It is noteworthy that intelligence was an important modifier of personality according to Ribot; later authors would also stress this. Gerard Heymans (1857-1930) was a professor of philosophy and psychology at the University of Groningen (in the Netherlands). He coauthored articles with Enno Dirk Wiersma (1858-1940), a professor of psychiatry at the same university.

4 months. Further therapies are needed to improve survival in men with hormone-resistant prostate cancer (HRPC), and a variety of potential avenues are under exploration to fill this void. Immunotherapy has become standard treatment in a wide variety of tumors. Such therapy includes cytokine administration (eg, interleukin [IL] 2 in metastatic renal cell carcinoma), monoclonal antibody therapy (eg, trastuzumab in breast cancer), and local immune stimulation (eg, Bacillus Calmette-Guéerin [BCG] for carcinoma in situ of the bladder). In prostate cancer, effective

immune strategies have been investigated for 25 years. Recent progress Inhibitors,research,lifescience,medical has been made in a variety of agents. This review outlines some of the recent advances in immunotherapy strategies for prostate malignancy. Tumor Immunology The immune system is divided into 2 components, innate and adaptive. The innate immune system includes neutrophils, macrophages/monocytes, mast cells, and natural killer cells. These cells are not specific to the invader and function by secreting cytokines, presenting antigens, Inhibitors,research,lifescience,medical and mediating cell lysis. Adaptive immunity includes lymphocytes, namely B cells and T cells, each of which responds to a specific antigen. Their

activity is modulated by exposure to that specific antigen. This portion of the immune system can be amplified and develops memory. Activated B cells mature into Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical plasma cells, which are responsible for antibody production. T cells exist in subsets based on cell-surface marker IKK Inhibitor VII mw expression. CD8 cells are referred to as cytotoxic T cells, whereas CD4 cells are termed helper T cells. CD4 cells direct the immune response through the secretion of cytokines, the maturation of B-cell/antibody responses, the

stimulation of CD8 T-cell cytotoxic responses, and antigen-presenting cell (APC) activity. In general, antitumor response is controlled by T cells, Inhibitors,research,lifescience,medical an overview of which is provided in Figure 1. Activation of T cells requires 2 signals, 1 signal through the T-cell receptor (TCR) and a second signal. The TCR interacts with major histocompatibility complex (MHC) class 1 and class 2 molecules (also termed human leukocyte antigen [HLA] 1 and 2) expressed on the cell surface. MHC 1 is expressed on all nucleated cells, presents peptide antigens from the cell itself, and interacts with the TCR of CD8 T cells. MHC 2 is expressed exclusively on APCs, Bumetanide presents peptide antigens taken up from the cellular environment, and interacts with the TCR on CD4 T cells. APCs include monocytes, macrophages, B cells, and dendritic cells. The second signal for T-cell activation often occurs through interaction of coreceptors between the two cells, the major one for the purposes of this review being an interaction between B7-1 on the APC and CD28 on the T cell. Figure 1 Schematic representation of the antitumor response and its modification by immunotherapy.

The first national survey in Israel, performed in 2002, identified 39 SCID patients, of whom 20 (51%) were T-B- SCID phenotype and 8 (20%) were T-B+ SCID phenotype.27 Nine years later, 14 new cases (T-B- SCID = 6 and Omenn syndrome = 8) were reported, and consanguinity was reported in 50% of the affected families.28 Interestingly, eight of the patients who had Omenn phenotype presented with normal numbers of lymphocytes and Inhibitors,research,lifescience,medical could therefore have

been misdiagnosed if absolute lymphocyte count-based methodology for the diagnosis of SCID had been used. Since the most frequent type of SCID genotype in Israel is the autosomal-recessive T-B- SCID, undetectable B cells in NBS is also very informative Inhibitors,research,lifescience,medical for the diagnosis of SCID and can immediately point to the specific abnormal gene (RAGs). This can be easily done simultaneously with TREC detection using quantification of KREC copies. The latter is used for the detection of newly produced bone marrow cells, making it a very sensitive and accurate way to estimate B lymphocytes. We recently assessed TREC and KREC counts to determine their ability to identify patients with combined T and

B cell immunodeficiency in Israel.29 Seven Israeli children who had been born between 2010 and Inhibitors,research,lifescience,medical 2011 and later diagnosed as having SCID were studied. TRECs and KRECs in their peripheral blood upon diagnosis and those in their neonatal Guthrie cards were analyzed using the accepted RTqPCR. The first features suggestive of SCID were presented at a mean age of 3.1 ± 2.4 months in all patients, but the diagnosis was not made until 4.1 ± 2.9 months later. Their TRECs were undetectable Inhibitors,research,lifescience,medical or significantly low during their clinical diagnosis and in their originally stored Guthrie cards, irrespective of the amount of their circulating T cells. KRECs were undetectable in the SCID patients who displayed B cell lymphopenia in addition to T cell lymphopenia. These results indicate that the quantification of TRECs Inhibitors,research,lifescience,medical is a sensitive and specific screening test for SCID and that the additional

quantification of KRECs can screen for B cell lymphopenia. It is quite logical to assume that several more children were not diagnosed; we estimate that isothipendyl every year about seven to eight new cases of SCID are born. Thus the true incidence is about 1/20–25,000 (annual birth number in Israel is around 170,000). In conclusion, measurement of TREC content has ERK pathway inhibitors become the best non-invasive clinical and research tool to investigate thymic activity. It allows the identification of recent thymic emigrants in peripheral blood and detection of T cell production by the thymus. It has recently been implemented in several states in the USA as a test to screen neonates for SCID, serving as the most sensitive and specific assay in such a devastating disease.

The well differentiated intestinal type is sporadic and highly associated with environmental exposures, especially H. pylori infection (13). There are also biologic differences between these subtypes of gastric cancer that may guide treatment approaches. H2N is over expressed more often in the intestinal vs the diffuse type, 30% vs 6% in Inhibitors,research,lifescience,medical one study (14). The Beta-catenin/Wnt signaling pathway is also recognized to play a large role in the molecular carcinogenesis of the intestinal type cancer (15). Despite the genetic heterogeneity of gastric cancer, several

biological determinants of risk and prognosis have been identified. Genetic polymorphisms of cytokines released with “oxidative stress” such as IL-Iβ, IL-10, and TNF-A have been associated with increased gastric cancer risk (16)-(18). Over expression of the oncogenes, tie-1, CMET and AKT have been found to confer a poor prognosis Inhibitors,research,lifescience,medical in both subtypes (19)-(21). Tumor expression of the isoenzyme COX-2 is an independent prognostic factor for gastric cancer survival (22). This benefit may be mediated by a reduction in lymphangiogenesis, another correlate of prognosis

(22),(23). Recently Her-2/Neu over expression, an important predictive and prognostic factor in breast cancer has been independently associated with a poor prognosis in gastric cancer (24),(25). Inhibitors,research,lifescience,medical The prognostic significance of age, gender, and ethnicity in metastatic gastric cancer is unclear. The prevailing belief that young patients with gastric cancer have a more aggressive disease has been recently called into question (26),(27). Several prospective and population studies since 1996 have Inhibitors,research,lifescience,medical consistently shown that age is not a prognostic factor for survival, despite the higher prevalence of “diffuse type” cancer which typically has a worse outcome (28),(29). However, according to a recent population-based study of gastric cancer, a significant impact of age on survival was found in patients with Inhibitors,research,lifescience,medical stage IV disease (30). As compared to women, men are twice as likely to develop and die from gastric cancer, in the US (1). Although this may

represent varying environmental exposures between genders, studies demonstrate that menstrual factors such as age of selleckchem menopause and years of fertility are associated with gastric cancer incidence (31). Liothyronine Sodium Interestingly, woman may be more likely to have a “diffuse type histology” (32). There are also significant ethnic and racial differences in gastric cancer incidence and survival. Asian patients consistently have increased survival rates compared to their western counterparts (33). Ethnic Asians living in the US share this benefit which suggests that these differences are not likely treatment related (34). Other racial differences in the US are notable as the incidence and mortality is 50% higher in African Americans than Caucasians (35).

Rather than rely solely on expert opinion, we utilized several strategies to inform the decision-making process. We performed a comprehensive literature review and made all publications containing original data available at the time of panel deliberations. In addition, we utilized our gap analysis to identify data needs and develop information targeted to those needs. To this end, we performed focused analysis of line-level data collected in the phase II and III clinical trials, a phase IV database created by the antivenom manufacturer, and a separate prospectively-collected database from a high-volume snakebite

Inhibitors,research,lifescience,medical treatment center. Whenever the above methods did not produce clear data to inform a treatment decision, we explicitly acknowledged this limitation in the manuscript. Conclusions Venomous snakebite Inhibitors,research,lifescience,medical is a complex and dynamic clinical entity that is characterized by a wide variation in clinical effects and response to therapy. Using a structured, evidence-informed Inhibitors,research,lifescience,medical decision-making process, we provide treatment guidelines that may reduce unnecessary variation in care and improve clinical outcomes. Competing interests SPB is an employee

of Faculty Medical Group of Loma Linda University School of Medicine, which has received research funding from Protherics. SPB derives no personal financial benefit from this relationship. EJL and RCD are

employees of the Denver Health and Hospital Authority, which has received research funding from Protherics. None of these authors derive personal financial benefit from this relationship. WB, VB, JNB, WPK, WHR, AMR, SAS, and DAT declare that Inhibitors,research,lifescience,medical they have no competing interests. The views expressed by VB and DAT in this article are those of the authors, and do not reflect the Inhibitors,research,lifescience,medical official policy or position of the US Air Force, the US Navy, the US Department of Defense, or the US government. Authors’ contributions EJL conceived the project. EJL and RCD secured funding. EJL drafted the initial version of the treatment algorithm. EJL, AMR, SPB, SAS, and staff of the Rocky Mountain Poison and Drug Center prepared data analyses for presentation at the meeting. WB, VK, JNB, SPB, WPK, WHR, AMR, SAS, DAT, and RCD were voting Resveratrol members of the expert consensus panel, which was chaired by a professional facilitator. SCC provided input during algorithm development and participated in the expert consensus panel as a non-voting member. EJL created the buy Adriamycin manuscript draft. All authors read, revised and contributed to the final manuscript. EJL takes responsibility for the work as a whole. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.

Inflammation Induced By Glycated Proteins, Interferon Gamma and Lipopolysaccharide It has been reported that glycated proteins trigger the inflammation. The pathophysiology of inflammation includes the recruitment of white blood

cells and production of cytokines which are the messenger among the cells.84 In addition, lipopolysaccharide (LPS), which is the outer membrane of gram negative bacteria, elicits the production of a number of cytokines.85 Cytokines can bind to specific receptors and trigger the complex Inhibitors,research,lifescience,medical cytokine network signalling. An excessively elevated level of cytokines was observed in AD patients. Among those, INF-γ, which was originally called macrophage-activating factor, is of potential interest.86 Macrophages are sensitive to INF-γ. Inhibitors,research,lifescience,medical In addition, the non lethal dose of LPS was shown to be toxic in combination with INF-γ in mice. The involvement of cytokines with LPS in buy STI571 Shwartzman-like lethal inflammatory response was observed in rabbits and mice.87,88 There is evidence that this protein modification results in the elevated level of cytokines.89 Inhibition of Inhibitors,research,lifescience,medical Glycated Protein Induced-Inflammation

by Different Antioxidants Inflammation is known as a potential cause of neurodegenerative diseases such as AD and Parkinson’s. Several studies have shown that neuronal cell death is regulated by inflammation. Microglia, the resident macrophages in the brain, can produce Inhibitors,research,lifescience,medical inflammation markers such as NO and TNF-α. The inflammation, which results in neurodegenerative diseases, has a deleterious effect on neurons.90 Reduction of inflammation might help to decrease the level of induced damages. Polyphenols are a group of compounds with defined structures and are abundant in fruit and vegetables. They are well known as antioxidants and antiinflammatory compounds.91

So far, the use of polyphenols as antiinflammatories has been studied extensively.92 The flavone structure is known as the antiinflammatory structure in a wide range of plant extracts. Resveratrol; however, Inhibitors,research,lifescience,medical belongs to a different structural family of plant extracts, and has stilbene structure (figure 4).93 The chemical structures of apigenin and resveratrol, their core structures, and related chemical groups are shown mafosfamide in figure 4.94 Inhibition of AGE-Induced Inflammation by Compounds Acting on the Receptors Protein glycation is a protein modification, and is observed in ageing. Glycated proteins can be up taken via the RAGE receptor.49 There are various ways to intervene at the receptor level in AGE-RAGE signalling pathway such as the blockade of the receptor by antagonist and antibody.95 The RAGE was implicated to be involved in AD and diabetic vascular diseases.96 Blockade of RAGE-ligand interaction by soluble RAGE, RAGE antibody and RAGE antagonist were considered in the reduction of plaque formation.97 The RAGE-ligand interaction triggers the AGE-RAGE signalling pathway.

No specific guidance is given on whether or not patients with pre-existing diabetes require closer monitoring; in these cases clinical judgement is often used. Recent studies have found an association between antipsychotic Crenolanib cost therapy and pneumonia. The link is better established in elderly patients with a possible dose-dependent relationship and increased odds ratio

in those treated with atypical antipsychotics [Trifirò et al. 2010; Knol et al. 2008]. More specifically, in the adult population an association between fatal pneumonia and clozapine therapy is also suggested. In one study, pneumonia Inhibitors,research,lifescience,medical was found to be the primary cause of death in the majority of excess deaths seen in clozapine-treated patients [Taylor et al. 2009b]. The exact pathophysiological association between clozapine Inhibitors,research,lifescience,medical and pneumonia is unclear and it is important to note that this later study found that amongst the excess deaths, not one was found to have agranulocytosis at the time of death. Other possible mechanisms include aspiration pneumonia as a result of sialorrhea Inhibitors,research,lifescience,medical [Hinkes et al. 1996] or oesophageal dysfunction [Maddalena et al. 2004]; however, the exact process remains uncertain. Currently there is no formal guidance on monitoring

or early intervention for this complication in clozapine-treated patients. We present a case of a 43-year-old patient with schizoaffective disorder and pre-existing diabetes, who in the fourth week of clozapine therapy presented in a hyperglycaemic crisis and subsequently developed fatal pneumonia. We later discuss the clinical implications of safely monitoring

these rare but potentially fatal adverse Inhibitors,research,lifescience,medical effects. Case presentation Mr D was a 43-year-old patient of Afro-Caribbean origin, with an established diagnosis of schizoaffective disorder. He first became unwell aged 24 years and experienced numerous episodes of illness characterized by thought disorder, paranoid delusions Inhibitors,research,lifescience,medical and affective symptoms. These episodes were often associated with severe self neglect and aggression and required both voluntary and involuntary admissions to psychiatric wards for management. Despite often successful resolution of his symptoms with psychotropic management, Mr D was difficult to manage in the community because of poor compliance with medication, nonengagement with services and concomitant illicit drug use. In terms of function, he was able to live relatively Carnitine dehydrogenase independently early on in his illness, however he required more support over time. His physical health was also of concern; he developed type 2 diabetes mellitus at the age of 41, had hypertension and a degree of chronic obstructive pulmonary disease (COPD), all of which required medical treatment. Contributory factors were morbid obesity, sedentary lifestyle, poor diet and heavy smoking. Approximately 18 months before his death, Mr D was admitted to an acute psychiatric ward as an involuntary patient following a relapse in his mental state.

Conclusion The results of this open-label, single treatment, extension study shows that PR171 long-term treatment with OROS® hydromorphone is beneficial in the management of persistent, moderate-to-severe pain in patients with cancer. Competing interests ALZA Corporation, that manufactures the drug, funded the current study; Johnson and Johnson Pharmaceuticals

also contributed some funds for the editing of the current manuscript. MH was a paid advisor for Janssen-Cilag. Authors’ contributions MH and AT were investigators in this study and were involved in revising this manuscript for important intellectual content. JT contributed to the analysis of the study and reviewed the manuscript. Pre-publication history The pre-publication Inhibitors,research,lifescience,medical history for this paper can be accessed here: http://www.biomedcentral.com/1472-684X/8/14/prepub Inhibitors,research,lifescience,medical Acknowledgements The authors would like to thank Nancy Milligan of Dianthus Medical Limited for preparing the draft manuscript on behalf of Johnson & Johnson Pharmaceutical Services in accordance with the European Medical Writers Association guidelines. The authors wish to thank the principal investigators of the study: Professor Hilary Thomas (The Royal Surrey County Hospital, Guildford, UK); Dr Janet Hardy (The Royal Marsden Hospital, Sutton, UK); Dr Alberto Tuca Rodriguez, Inhibitors,research,lifescience,medical Jose Espinosa Rojas, and Jordi Trellis i Navarro (Institut

Inhibitors,research,lifescience,medical Catala de Oncologia, Barcelona, Spain); Dr Brigitte George

(Hopital Saint-Louis, Paris, France); Dr G Van Oss (Ziekenhuis Rijnstate, Ta Arnhem, Netherlands); Dr R van Leersum (RodeKruis Ziekenhuis, den Haag, Netherlands); Dr P Dellemijn (St Joseph Ziekenhuis, Veldhoven, Netherlands); Dr A Vielvoye-Kerkmeer (Antoni Van Leeuwenhoek Ziekenhuis, Amsterdam, Netherlands); Dr J Douma (Rijnstate Ziekenhuis, Ta Arnhem, Netherlands); Dr Christof Muller-Busch, Dr Thomas Jehser, and Dr Inge Andres (Gemeinschaftskrankenhaus Inhibitors,research,lifescience,medical Havelhoehe, Berlin, Germany); Dr Bernd Konior and Dr Detlef Hellwig (Universitatsklinik, Marienhospital I, Herne, Germany); Dr A Bols, Dr P Van Kerkhove, and Dr G Demeestere (A Z Sint Jan, Bruges, Belgium); Dr F Opsomer and Dr S Goossens (Middelheimziekenhuis, because Antwerp, Belgium); Dr E Salamon and Dr A Vandeveire (Clinique St Elizabeth, Namur, Belgium); Dr C Laurent, Dr S Marichal, and Dr C Dubois (Hopital Saint-Jean, Brussels, Belgium); Dr Dwight Moulin (London Health Sciences Centre, London, Canada); Dr Neil Hagen (Foothills South Tower, Calgary, Canada).
Clinical guidance recommends early CHF palliative care intervention, but the magnitude of need is unknown and evidence-based referral criteria absent. This study aimed to: 1) Measure point prevalence of inpatients appropriate for palliative care. 2) Identify patient characteristics associated with palliative care appropriateness. 3) Propose evidence-based clinical referral criteria.