In this study, the major cause for conversion was an inadequate l

In this study, the major cause for conversion was an inadequate laparoscopic resection leading to an inadequate excision. Preoperative colonoscopic tattooing was a safe and effective method for tumor

localization in laparoscopic colorectal surgery (25). Intraoperative colonoscopy was also a way of definitively localizing a lesion (26). Port site recurrence has been reported after laparoscopic resection of colorectal cancer (0-1.4%) (24,27). In the present Inhibitors,research,lifescience,medical study, there was no port site recurrence. More importantly, there was no difference in overall and disease-free survival between minilaparotomy and laparoscopic group, and local and distant recurrence rates were similar in both groups. Similar results that supported the equivalence of oncologic outcomes have been reported in several single-institution comparative or randomized controlled studies (16,17,28). This study indicates that the minilaparotomy approach is oncologically feasible. In this study, splenic flexure mobilization was conducted when necessary in the laparoscopic approach, Inhibitors,research,lifescience,medical but could not be performed in the minilaparotomy approach because of small incision. Some surgeons, especially those in Western countries, have suggested that wide splenic flexure mobilization was crucial to obtain adequate resection with tension-free anastomosis in rectal cancer

surgery (29). However, Inhibitors,research,lifescience,medical we found that most patients need not splenic flexure mobilization to complete the anastomosis in the minilaparotomy approach, unless some Inhibitors,research,lifescience,medical patients with very short sigmoid colon and large quantities of mesentery fat. Some investigators from Asian countries have shown that Laparoscopic and open procedures without routine splenic Inhibitors,research,lifescience,medical flexure mobilization in the treatment of rectal cancer was feasible and did not seem to increase postoperative morbidity or oncologic risk (30,31). The patients in minilaparotomy group were not overweight, because obesity was

the risk factor preventing the success of the minilaparotomy approach in the resection of colorectal from cancer (32), and almost all surgeons seem to agree that obesity reduced the technical feasibility of the minimally invasive laparoscopic and minilaparotomy approaches (3,10,11). Since the incidence of overweight or morbidly obese patients in Asia is probably lower than in Western countries (12,33), we feel that minilaparotomy is a suitable technique for many Asian patients with rectal cancer. In conclusion, minilaparotomy approach is comparable to the laparoscopic approach in terms of postoperative complications and oncological outcomes, CO-1686 in vivo demonstrating the feasibility and the efficacy of the minilaparotomy approach. Laparoscopic approach has an advantage over minilaparotomy approach in allowing earlier recovery. However, this is at the expense of a longer operating time and higher direct costs.

Also 19% of Smith et al’s [29] data was obtained by proxies who m

Also 19% of Smith et al’s [29] data was obtained by proxies who may have underreported musculoskeletal symptoms [16]. Smith et al’s [29] study used the time between interview and death to document a significant increase in pain prevalence in Selleck LY2835219 people with arthritis as death approached. The authors highlighted the limitations of using cross sectional data in this fashion. Despite this, the findings emphasise the need to be especially vigilant for pain in people with co-morbid musculoskeletal

disease in the final months of life [32]. Borgsteede et al [30] supported this by showing that musculoskeletal Inhibitors,research,lifescience,medical symptoms were prevalent in at least 20% of patient-GP encounters during the last three months of life. This is higher than the 14% annual prevalence of GP consultations for musculoskeletal Inhibitors,research,lifescience,medical disease in the general population reported by Jordan et al [33]. However, the studies were undertaken in different countries and used different systems for classifying consultation data making direct comparison difficult. Furthermore, Borgsteede et al [30]

gave no information about Inhibitors,research,lifescience,medical the nature or severity of the symptoms, nor does it discuss how, or whether, they were successfully managed in practice. Borgsteed et al [30] suggested that their study may have underestimated the prevalence of musculoskeletal symptoms as GP’s were unlikely Inhibitors,research,lifescience,medical to register all the symptoms affecting patients at the end of life and the records represented the most important symptoms as perceived by the GPs, rather than documenting the patients perspective [30]. Smith et al [29] may also have a systematic bias underestimating the true prevalence of musculoskeletal pain. The health and retirement study excluded people living in institutions, and admission to care homes

is commonly prompted by reduced physical functioning [34]. Although both population based studies Inhibitors,research,lifescience,medical found musculoskeletal disease had a significant impact at the end of life, the prevalence of symptoms recorded varied significantly: 60% in Smith et al [29] and 20% in Borgsteede et al [30]. As Smith et al [29] does not discuss how ‘arthritis’ was defined and Borgsteede et al [30] do not discuss the nature to of the musculoskeletal symptoms, comparison is difficult. The extent of the disparity is similar to that observed when estimates of musculoskeletal pain from population surveys are compared with estimates derived from coded primary care data, with surveys consistently suggesting that only a minority of people raise the issue of even severe musculoskeletal pain with their GP [35]. Nevertheless the fact that these figures do not more closely correspond provides tentative initial support for the idea that musculoskeletal pain is common at the end of life, but underestimated as a cause of pain by healthcare professionals.

For cardiovascular regeneration, more robust selection markers an

For cardiovascular regeneration, more robust selection markers and refined experimental protocols are required to reproducibly guide iPSCs to a cardiovascular lineage.15, 18 Furthermore, GSK2118436 research buy effective negative selection against pluripotent cells is necessary to avoid teratoma formation by contaminating pluripotent stem cells.19 There is also the concern that autologous iPSC-derived cells may acquire genetic

or epigenetic alterations during the reprogramming or differentiation process and/or may recapitulate the vascular disease Inhibitors,research,lifescience,medical of the patient from which they were obtained. However, great strides have been made in refining iPSC generation since Shinya Yamanaka first used a retroviral approach to overexpress the reprogramming factors. 4, 6, 20 Because this approach Inhibitors,research,lifescience,medical raised concerns regarding the integration of foreign DNA in the host genome, effective nonviral strategies for induction of pluripotency were developed. Our group has employed protein-based approaches to deliver reprogramming factors for generating iPSCs. In doing so, we have discovered the effect of innate immune activation in effective reprogramming, a finding that will lead to therapeutic ramifications.20 Conclusion Induced pluripotent stem cells hold great promise

for cardiovascular regeneration because of their unlimited Inhibitors,research,lifescience,medical capacity for proliferation and differentiation. iPSC technology already has enabled an exciting new approach for disease modeling and drug screening. Despite the great progress, the clinical use of iPSC technology is still in its infancy, and many technical hurdles remain. Ultimately, we and others intend to develop personalized Inhibitors,research,lifescience,medical cell therapies in the treatment of peripheral artery and heart diseases.21, 22 Funding Statement Funding/Support: Dr. Cooke receives research funding from the National Institutes of Health, Dr. Sayed is supported Inhibitors,research,lifescience,medical by a NIH postdoctoral fellowship (HL098049-01A1)

and American Heart Association Scientist Development Grant (AHASDG) (13SDG17340025), and Dr. Wong is supported by a postdoctoral fellowship (12POST8830020) and Scientist Development Grant (13SDG15800004) from the American Heart Association. Footnotes Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict not of Interest Statement and none were reported. Contributor Information Wing Tak Wong, Houston Methodist Hospital Research Institute, Houston Methodist Hospital, Houston, Texas. Nazish Sayed, Houston Methodist Hospital Research Institute, Houston Methodist Hospital, Houston, Texas. John P. Cooke, Houston Methodist Hospital Research Institute, Houston Methodist Hospital, Houston, Texas.
Introduction Cardiovascular disease is a major public health problem that imposes a huge economic burden on health systems around the world, and patients with end-stage heart failure (HF) represent a large share of the healthcare spending.

Follow-up information was collected until the first of the ensuin

Follow-up information was collected until the first of the ensuing events occurred: death of the patient, loss to follow-up, transplantation or hepatectomy. Primary and secondary issues The occurrence of click here cytolysis following chemoembolization was our main variable of interest. We used the definition by Paye et al. for cytolysis that is an elevation

of AST above 100 UI/L with at least a doubling of the baseline value for AST (12) occurring within the first 5 days following treatment. Our primary issue was to evaluate if cytolysis was associated with a favourable radiological response Inhibitors,research,lifescience,medical two months after treatment. Our secondary issues were to investigate if cytolysis was associated with the development of hepatobiliary complications and overall survival. Liver failure was defined as the development of hepatic encephalopathy, doubling of baseline bilirubin, 25% increase in INR or appearance of ascites during the hospitalisation post TACE. Statistical analysis The statistical analysis was twofold: Inhibitors,research,lifescience,medical first, we considered the treatment outcomes using the treatment

as the unit of interest, as patients could undergo several sequential treatments. Second, we analysed the survival-related outcomes, this time using the patient as the unit of interest. When the unit of analysis was the treatment, generalized estimating equations (GEE) with an exchangeable correlation Inhibitors,research,lifescience,medical structure were used to account for the correlation between Inhibitors,research,lifescience,medical multiple treatments from the same patients. Continuous variables expressed as mean (standard deviation, sd) were compared with the Student t test when the unit of analysis was the patient. Similarly, categorical variables were compared using GEE at the treatment level and with the chi-square test at the patient level. We constructed Kaplan-Meier curves for the time to death according to the presence or absence of cytolysis at the time of the first treatment. Cases were censored in case of transplantation or loss to follow-up. Administrative censoring was set at 18 months after the Inhibitors,research,lifescience,medical first treatment. Association among demographic, biochemical and

prognostic Vasopressin Receptor score variables was estimated using multivariable Cox’s proportional hazards regression model. Variables selected were those that are known to be associated with survival from liver cancer and liver disease and included the alphafetoprotein (AFP) levels (16,17), Okuda score (18,19) or CLIP score (18,20,21), MELD score and patient’s age. The natural logarithm of the AFP was used for the analysis to improve the fit of the regression model. To account for the impact of tumour differentiation on the response to chemotherapy, radiological response was adjusted according to the log of the alphafetoprotein levels as high AFP levels are associated with poorer tumour differentiation (22). Analyses were performed using R version 2.13.1 (The R Foundation for Statistical Computing, Vienna, Austria) statistical software and Stata v. 11.

(91% had local protocols) Placement (more than one answer allowed

(91% had local protocols) Placement (more than one answer allowed): 55% BL (25% BL only) 2% BF 40% RUL 2% RFT 2% not described Mainly UL first, then change to BL France (L) Benadhira R (Benadhira and Teles 2001) Study: Questionnaire survey to all 815 French Psychiatric Public Hospital services N= 391 (response rate 48%) 51% of, responded hospitals administered ECT Period: 1996–1997 Time span: One year Diagnoses: 63% medication resistant depression 18% schizophrenia 10% mania Gender and age: not reported Other: Only half of all hospitals Inhibitors,research,lifescience,medical in France administer ECT No rate/prevalence data Modified Anesthesia: 65% PF-562271 mw Propofol 24% Thiopenthal Device: 55% Thymatron DG/Mecta SRI 44%Lapipe et Rondepierre Type:

brief pulse and sine wave Placement: 18% UL Denmark (L) Andersson JE (Andersson and Bolwig 2002) Study: Questionnaire survey to hospitals in Denmark, Greenland, and Faroe Islands N= Inhibitors,research,lifescience,medical 35 clinics, (100% response) All provided ECT N= 1556 patients received ECT Period: 1999 Time span: One year Diagnostic

indication from 35 units (%): 35 (100%) depression 28 (80%) delirium 22 (63%) mania 12 (34%) schizophrenia 5 (14%) other Training: Provided by 49% (17 of 35) institutions. Psychiatrist administering ECT. In most institutions, junior doctors performed ECT. TPR: 3.0 iP: 5% (1.8–10.0%) AvE: Inhibitors,research,lifescience,medical 9 (range 6–18) Anesthesia, 33 units (%): 28 (85%) Barbiturate 3 (9%) propofol 2 (6%) unknown Devices and Type: Thymatron or Mecta (brief-pulse wave) one Siemens konvulsator

device (sine wave) Denmark Inhibitors,research,lifescience,medical (L) Sundhedsstyrelsen (Sundhedsstyrelsen 2011a) Study: National register data, 2000–2007 N= 17 psychiatric units, hospitals No. of ECT-treated patients/ECT administrations per year: 260/2336 (2000) 313/3237 (2001) 460/4686 (2002) 1399/15,174 (2003) 1563/16,606 (2004) 1786/19,173 (2005) 1774/19,389 (2006) 1772/19,127 (2007) Main indication: Elderly depressed patients Side effects: No. of deaths 24 h after ECT in study period = 6 and evaluated as not ECT-related Conditions: Prevalence of involuntary ECT treated patients (supplementary ECT data from same online source ( Inhibitors,research,lifescience,medical in Use of coercion in Mental Health Care, 2009 (Sundhedsstyrelsen 2011b): 2.8%[722/25,199] (2002) AvE per year: 11.1 (2000) 9.2 (2001) 9.8 (2002) 9.2 (2003) 9.5 (2004) 9.3 (2005) 9.1 (2006) 9.2 (2007) No information Period: 2000–2007 Time span: Seven years Bay 11-7085 2.6%[667/25,291] (2003) 2.8%[714/24,872] (2004) 2.9%[734/24,501] (2005) 3.1%[765/24,308] (2006) 3.1%[736/24,129] (2007) 3.3%[821/24,311] (2008) 3.2%[848/26,014] (2009) Guidelines: Not all institutions followed all instructions, developed by Sunhedsstyrelsen guidelines no. 9001, 20 November 2000. Other: High increase in no. of ECT-treated patients from 2000 to 2007. Norway (L) Schweder, LJ (Schweder et al. 2011a) Study: Questionnaire survey to psychiatric hospitals, mental health care community centers, including child and adolescent psychiatry about ECT practice.

This observation merits further validation as both baseline and e

This observation merits further validation as both baseline and early change in CTCs may prove to be useful to guide therapeutic decisions and to predict clinical outcomes. Conclusions This is the first report to show a clinical observation of detectable CTCs in patients with cancers of biliary origin. In this pilot study using a cutoff Inhibitors,research,lifescience,medical of 2CTCs/7.5 mL, 25% of patients with biliary cancer had detectable CTCs. Our results suggest that positive as well as negative CTC results may have prognostic value in predicting outcomes but need prospective validation. Our group is currently conducting a prospective study to determine the value of baseline

and change in CTCs during chemotherapy. This trial may help define the optimal CTC cutoff in predicting clinical outcomes in advanced biliary cancer patients. Funding Dr. Iyer

is supported by a grant from the American Inhibitors,research,lifescience,medical Cancer Society (MSRG -08-096-01-CCE). This research was supported, in part, by the National Cancer Institute (NCI) Support Grant to the Roswell Park Cancer Institute [P30 "type":"entrez-nucleotide","attrs":"text":"CA016056","term_id":"24293400","term_text":"CA016056"CA016056]. Footnotes No potential conflict of interest.
Since the first report in the 19th century, there have been numerous reports on the isolation and characterization of circulating Inhibitors,research,lifescience,medical tumor cells (CTCs) in peripheral blood in patients with various cancers (1-3). Recent studies have shown that the malignant Inhibitors,research,lifescience,medical characteristics of CTCs are genetically similar to the primary tumor (4,5). However, their characterization is of considerable biomedical interest in order to understand how these cells

can travel via the blood stream to anatomically distant sites and form metastatic disease. There have been many investigations which showed the utility of CTCs in the peripheral blood as a valuable Inhibitors,research,lifescience,medical diagnostic tool or a predictor of the clinical outcome in patients with solid tumors (2,3). In general, CTCs have been observed in the peripheral blood of cancer patients at very low concentrations of 10-7-10-8 of normal peripheral blood cells (6,7). Therefore, the detection of CTCs in blood requires highly sensitive, specific, and reproducible methods. To date, several methods including immunocytochemistry, reverse-transcription polymerase chain reaction (RT-PCR) or PCR procedures, and flow cytometry have been used for the detection of these rare CTCs no in the peripheral blood (2,3,7,8). Moreover the CTC-detection systems using the PS-341 mouse immunobead-based assays during the past ten years were designed to detect tumor cells in blood (9). By use of these systems, it is possible to obtain highly reproducible quantitative results. In particular, recently developed CellSearch System (Veridex LLC, Raritan, NJ) was designed to quantify the tumor cells in whole blood (9).

72 in recognition of BE ≥1 cm, however the RC dropped to 0 22 whe

72 in recognition of BE ≥1 cm, however the RC dropped to 0.22 when less than 1 cm of columnar-lining was present. This is the endoscopic classification system currently suggested by the American College of Gastroenterology (4). A recent small study by Kinjo et al. (48) suggests that recognition of ultra-short segment BE may be improved using the Japanese EGJ reference point (the distal end of the palisade-shaped longitudinal vessels) rather Inhibitors,research,lifescience,medical than the traditional proximal limit of the linear gastric mucosal

folds currently utilized in the Prague C&M criteria, but more information is needed to determine if these results are reproducible and applicable outside of the Japanese population. Histologic features of Barrett’s

esophagus and PERK inhibitor dysplasia Clinicians and pathologists have defined BE to include not only a characteristic endoscopic appearance to the esophagus but also histologically confirmed intestinal metaplasia consisting of columnar epithelium Inhibitors,research,lifescience,medical with well-formed goblet cells (1). Goblet cells are recognized by a large cytoplasmic vacuole filled with blue-tinted mucin. During carcinogenesis, Inhibitors,research,lifescience,medical the tissue develops morphologic changes related to unregulated cell growth that can be recognized as dysplasia on microscopic examination (49). The spectrum of changes is subdivided into four clinically significant groups: negative for dysplasia, indefinite for dysplasia, low grade dysplasia, and high grade dysplasia. Patients with histologically confirmed dysplasia have been shown to have significantly increased risk of progression to EAC (33,50-52). Despite concerns over adequate sampling and imperfect Inhibitors,research,lifescience,medical intra- and interobserver reproducibility (particularly at the low end of the dysplasia spectrum), histologic

evaluation for dysplasia retains a key role in the surveillance of patients with BE (4,33,53). Due to the significance of identifying dysplasia, Inhibitors,research,lifescience,medical much work has gone into clarifying and refining the criteria used to interpret biopsies (33,54-57). The degree of dysplasia is determined by evaluating the cytology (nuclear and cytoplasmic features), architecture (relationship of glands and lamina propria), and degree of surface maturation (comparison of nuclear size within crypts to nuclear size at the mucosal surface) and interpreting these findings in conjunction Thymidine kinase with the amount of background inflammation. Features of each category of dysplasia are described below and summarized in Table 1. Table 1 Categories of dysplasia: Histologic features and suggested endoscopic surveillance (4,33,53) Negative for dysplasia – These biopsies can have a minimal amount of cytologicatypia but retain normal architecture, abundant lamina propria between glands, and appropriate maturation with a low nuclear:cytoplasmic ratio at the mucosal surface. The nuclei are regular, have smooth membranes, and are basally situated. If mitoses are present they are within the basal compartment.

Consequently, any conflicts over the development of new healthcar

Consequently, any conflicts over the development of new healthcare roles moved from the ‘ideological’, to consideration of measurable outcomes, which now provided the basis for decisions. In EDs, the new professional role of the ENP, a specialised nurse for the purpose of taking up mundane tasks and releasing time for doctors, was developed to strengthen Inhibitors,research,lifescience,medical the focus on the target. These nurses were trained to act autonomously, based on protocols, in health promotion, education, assessment, diagnosis

and interpretation of X-Rays, while they can treat and prescribe medications for minor illnesses and injuries [58,59]. They are now considered an effective solution for reducing wait times, particularly in overcrowded urban EDs with high volumes of low acuity patients and physician

shortages [60]. Most of the interviewees in our study thought ENPs made an invaluable contribution to the reduction of target breaches. We have already seen how the focus on the target as a means of addressing the chronic problem of ED wait times led to the replacement of one big queue, in which Inhibitors,research,lifescience,medical every patient was prioritised, with a smaller, more manageable, and less visible queue. In conjunction with the new system, an added benefit of this change was that these patients could have more information regarding their position in this queue which “does help them”. For example, patients Vorinostat waiting could be informed about how Inhibitors,research,lifescience,medical many people were in front of them. EDAs at the Inhibitors,research,lifescience,medical reception, while they could not know precisely how long a patient would have to wait, could look up the queue in EDIS and reassure these patients that they were “still on the system, everything is in time order” and that they would not “get missed”. On the other hand, this was only for those patients who are accepted into these queues. Just like the clinicians who managed

their trajectories, patients were subjects of the Inhibitors,research,lifescience,medical same target. The target acted as the objective justification for exclusions. Patients, whose medical condition did not meet the profile of the ED attendee, were referred to other services (e.g. GPs, minor injury units and walk-in centres). “Before, we couldn’t have sent anybody away, first we didn’t have that sort of authority to send people away, so it was like well…you’re not important to be seen, so everyone needs to be seen before you, so if you’re waiting here 6 hours that’s how long you will wait” (Clinician 5). For those patients who had successfully managed to navigate themselves through the maze of the healthcare system and had been given a ‘boarding pass’ to the ED, a better clinical experience and quality of care was “pledged” [61]. This was evident from the fact that almost all of our participants stated that they would not want to go back to the previous clinical reality of EDs with “doctors sitting on the floor doing assessments” and patients “who had been waiting two days to get to a ward”.

The mailed brochure is a common health education format that was

The mailed brochure is a common health education format that was conceptualized as the control condition for the study. Correctly recalled and applied CPR steps are essential in lifesaving. Studies have shown that the quantity and spacing of refreshers

is related to the degree of subsequent skill this website retention [40,41]. Thus the present study also tested whether repeating the CPR refresher episodes was useful for proper sequencing of skills in administering CPR. The primary study hypothesis is that the three novel, technologically “active” CPR refreshers, Inhibitors,research,lifescience,medical will yield outcomes superior to those of the relatively passive, traditional mailed brochure refresher. (We do not hypothesize the relative efficacy of the three novel refreshers; this aspect of

the analysis is exploratory.) The secondary study hypothesis is that subjects receiving two refresher episodes will have outcomes superior to subjects receiving only a single refresher Inhibitors,research,lifescience,medical episode. Methods Interventions Using clear, concise visual depictions, Each of the four refreshers described below reviewed the five principal CPR skills: (1) checking for responsiveness, (2) calling 911, (3) ventilation, Inhibitors,research,lifescience,medical (4) compression, and (5) hand placement. Each refresher included separate visual and narrative (written and/or audio) depictions of procedures for conducting CPR. To avoid information overload for the subjects, we limited the content of the refreshers and subsequent re-tests to adult CPR procedures. Online website Subjects received an e-mail with a link to the CPR refresher website, which consisted of 10 modules. Users were presented with refresher information and Inhibitors,research,lifescience,medical scenarios based on their unique learning profile driven by the above theoretical constructs. The application of these skills to a situation of bystander assistance was followed by a review of the five basic skills. Additional guided experiences were presented, allowing

the subject to apply their Inhibitors,research,lifescience,medical knowledge, skills, readiness, efficacy, and intent to various scenarios. The approach used within this intervention differs significantly from that which would be found in a traditional educational course approach. It was not the intent of the website to Thiamine-diphosphate kinase replicate or serve as an educational course, as online CPR courses currently exist. Rather, the basis of the website is dynamic in the sense that users are directed toward refresher information that is keyed to their stated degree of confidence in being able to perform actions associated with the five CPR skills. The website focused on review of skills based on where the user was in relation to their confidence to engage in CPR administration. Prior to this, no web-based approach had been developed that provides refresher intervention which is stage-based and designed to enhance intent to engage in CPR administration behaviors. E-mail A series of 12 e-mail messages was sent to subjects over the span of one month.

This certainly implies that the discussions, despite not being st

This certainly implies that the discussions, despite not being structured, were very much of a collegial nature, which in theory leads to a decision with the agreement of participants in institutions admitting people suffering from very advanced dementia.

The participants were not, however, compelled to mention their feelings in relation to a case, and it is significant that the anonymity which we tried to maintain so that each person could feel “listened to” without value judgement was very often discarded by the individuals themselves. The card sorting method in groups was adopted after the study by several gerontology teams for their ordinary #Angiogenesis inhibitor keyword# decisions [21]. Competing interests The authors declare that they have no competing interests. Authors’ contributions LP, CV, DFC, JLB, PP and RA developed the study concept. RA coordinated the study. LP and CV conducted the statistical analysis and developed the study design. SG and FS conducted the interviews. DFC, SG, Inhibitors,research,lifescience,medical FS, EC, JLB, PP and RA carried out the interpretation of the data. LP and RA Inhibitors,research,lifescience,medical supervised the interviews. LP and CV wrote the manuscript and all authors reviewed and approved it. Pre-publication history The pre-publication history for this paper can be accessed here:

Acknowledgements The authors are indebted to Miss Frances Sheppard (CIC-Biotherapy 506, Besançon, France) for her help in preparing the manuscript. Funding This work was supported by the hospital clinical research programme from the French Ministry of Health.
Although palliative care is meant

to “provide… spiritual and psychosocial support from diagnosis to the end of life and bereavement”, there are few tested, systematic interventions Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical available to address psychosocial and existential sources of distress among cancer patients admitted to palliative care [1]. Interventions targeting end-of-life distress are therefore highly relevant, to help patients live as fully as possible and to support the bereaved. Dignity Therapy (DT) was developed by Chochinov and colleagues based on their previous research on the concept these of dignity [2-4]. DT is based on an empirical model of dignity in the terminally ill, which delineates what influences an individual’s sense of dignity. The purpose of DT is “to decrease suffering, enhance quality of life, and bolster a sense of meaning, purpose and dignity” [5]. Dignity Therapy employs a narrative approach and contains elements similar to Life Review and reminiscence, with its focus on letting the patient find meaning and reconciliation through examining past experiences and achievements, and making amends with or carry out unfinished business [6-9]. It also contains elements from meaning-centered therapies, in terms of creating legacy [10-14]. Further, DT focuses on meaning-making, by inviting patients to reflect on what is important to them.