scholarly journals Turismo de células madre

2012 ◽  
Vol 61 (1) ◽  
Author(s):  
José Luis Pérez Requejo ◽  
Justo Aznar Lucea

Mai prima d’ora i pazienti gravemente malati o con malattie incurabili o croniche, sono stati così esposti a organizzazioni mediche senza scrupoli, che approfittando del loro logico disagio e della loro preoccupazione promettono cure miracolose e trattamenti, facendo pagare enormi somme di denaro per procedure senza alcuna garanzia, alcun reale beneficio e, peggio ancora, con gravi rischi per la salute. Questo articolo discute alcuni casi di pazienti che hanno pagato con la loro salute, spesso irrimediabilmente, o in maniera catastrofica, gli effetti di terapie teoricamente avanzate con cellule staminali di alcuni centri. Ci si è riferiti a diversi paesi che, in tempi anche non remoti, offrono e praticano qualcuno di questi trattamenti, il più delle volte attraverso strategie di marketing dirette e aggressive per i pazienti o le loro famiglie, mostrando reale o fittizi rapporti relativi ad altri pazienti, ma senza previ studi scientifici che avvalorino i risultati dei presunti benefici. In questo articolo, discutiamo alcuni utili suggerimenti e linee guida internazionali per riconoscerli ed evitarli. Inoltre, abbiamo discusso in dettaglio le ragioni specifiche per cui la maggior parte dei medici e clinici sollevino dei dubbi sulla competenza e le ragioni etiche di questi centri e scoraggino i viaggi di questo “turismo medico”. È sempre consigliabile chiedere il consiglio del medico di famiglia o specialista, prima della decisione dei pazienti di ricevere trattamenti dubbi, con la certezza che il paziente avrà sempre la sua comprensione e il supporto emotivo e medico. ---------- Never before seriously ill patients with chronic or incurable diseases have been so exposed to unscrupulous medical organizations that, taking advantage of their logical distress and worry, promise miracle cures and treatments and charge them huge amounts of money for procedures with no guarantee, no real benefits and, even worse, with serious risks to their health. This paper discusses some cases of patients who paid with their health, often irreparably, or catastrophically, the effects of supposedly advanced therapy centers with stem cells. Several countries are mentioned, not always as remote, which offer and practice any of these treatments, most often by direct and aggressive marketing to patients or their families, showing real or fictional accounts of other patients, but without the previous studies and scientific papers that endorse their supposed beneficial results. In this article we discuss some useful hints and international guidelines to recognize and avoid them. Also, we discussed in detail the specific reasons why most doctors and clinics doubt about the competence and ethical reasons of these centers and discourage those “medical tourism” trips. It is always advisable to seek the advice of the family doctor or specialist in charge, before the patients decision to receive dubious treatments, with the assurance that, decide what the patient decide, they will have always his understanding and his emotional and medical support.

1969 ◽  
Vol 14 (1) ◽  
pp. 29-35 ◽  
Author(s):  
A. McL. Jenkins ◽  
W. M. McQuillan ◽  
T. J. McNair

A survey of 100 seriously ill patients admitted to a Resuscitation Room is described. The survey was conducted over a comparatively short space of time, but it has nonetheless illustrated several facts. The remarkable frequency of violence and poisoning among patients requiring resuscitation is demonstrated. This combined group constitutes over 80 per cent of all the patients. Also notable is the frequency of head injury, and in particular the high percentage (75%) of patients who received their head injuries in road traffic accidents. The Neurosurgical Unit is shown to receive far more patients from the resuscitation room than any other unit, and this fact might be usefully employed in planning the proximity of such units to casualty departments of the future. The use of a specially equipped resuscitation room is described. It is clearly desirable to have such an area, but with the relatively small number of resuscitation patients it is not economical to restrict the very expensive X-ray facilities to these patients alone.


2021 ◽  
pp. 01-03
Author(s):  
Anurag Bhargava

Physicians in countries like India have to take on the care of seriously ill patients that, in a strict sense, maybe beyond their means to handle. They do so often because their patients trust them or the institutions that they may be a part of. The author reflects on his stint as a young physician in a rural medical college in Gujarat in the 1990s. He narrates the experience of dealing with a critically ill young man brought by road from a hospital in Bombay, 500 km away, to his hometown. The patient survived because the correct diagnosis was reached, and the family assisted in his intensive care with a remarkable composure which owed its origins to a faith crossing the boundaries of religion.


2016 ◽  
Vol 37 (5) ◽  
pp. 544-554 ◽  
Author(s):  
Katherine R. Courtright ◽  
Vanessa Madden ◽  
Nicole B. Gabler ◽  
Elizabeth Cooney ◽  
Jennifer Kim ◽  
...  

Background. Evidence suggests that advance directives may improve end-of-life care among seriously ill patients, but improving completion rates remains a challenge. Objective. This study tested the influence of increasing the number of options for completing an advance directive among seriously ill patients. Methodology. Outpatients ( N = 316) receiving hemodialysis across 15 dialysis centers in the Philadelphia region between July 2014 and July 2015 were randomized to receive either the option to complete a brief advance directive form or expanded options including a brief, expanded, or comprehensive form. Patients in both groups could decline to complete an advance directive or take their selected version home. The primary outcome was a returned, completed advance directive. Secondary outcomes included whether patients wanted to complete an advance directive, decision satisfaction, quality of life at 3 months, and patient factors associated with advance directive completion. Results. Although offering more advance directive options was not significantly associated with increased rates of completion (13.1% in the standard group v. 12.2% in the expanded group, P = 0.80), it did significantly increase the proportion of patients who wanted to complete an advance directive and took one home (71.9% in standard v. 85.3% in expanded, P = 0.004). There was no difference in satisfaction ( P = 0.65) or change in quality of life between groups ( P = 0.63). A higher baseline quality of life was independently associated with advance directive completion ( P = 0.006). Conclusions and Relevance. These results suggest that although an expanded choice set may initially nudge patients toward completing advance directives without restricting choice, increasing actual completion requires additional interventions that overcome downstream barriers.


Aquichan ◽  
2021 ◽  
Vol 21 (1) ◽  
pp. 1-3
Author(s):  
Clare Butt

During this COVID-19 global pandemic, seriously ill patients rely on nurses more than ever. Providing care in the altered environment of the pandemic can be stressful for nurses and the interdisciplinary team. Faced with limited time and resources, restricted visiting of family members and loved ones, and the changing science affecting treatments, nurses are extraordinarily challenged. Fortunately, nurses can benefit from integrating palliative care nursing skills into all levels of care. Because palliative care is holistic, improves the quality of life, and focuses on both the patient and the family, it can assist nurses—from acute care to home care settings—in managing symptoms, communicating with empathy, and discussing care decisions. Importantly, despite the enormous stress of these uncertain times, nurses can take the time to care for themselves and thereby find the strength to continue caring for patients.


Medic ro ◽  
2018 ◽  
Vol 5 (125) ◽  
pp. 33
Author(s):  
Liliana-Ana Tuţă ◽  
Laura Condur ◽  
Alina Mihaela Stăniguţ ◽  
Camelia Pană

2020 ◽  
pp. 15-18
Author(s):  
Nina Tishchenko

The article reflects the importance and importance of the work of nurses of the Department of Palliative Care for Oncological Patients of the State Budget Health Establishment «Samara Regional Clinical Oncological Clinic». Important stages and features of care when dealing with seriously ill patients.


2021 ◽  
pp. 108482232199038
Author(s):  
Elizabeth Plummer ◽  
William F. Wempe

Beginning January 1, 2020, Medicare’s Patient-Driven Groupings Model (PDGM) eliminated therapy as a direct determinant of Home Health Agencies’ (HHAs’) reimbursements. Instead, PDGM advances Medicare’s shift toward value-based payment models by directly linking HHAs’ reimbursements to patients’ medical conditions. We use 3 publicly-available datasets and ordered logistic regression to examine the associations between HHAs’ pre-PDGM provision of therapy and their other agency, patient, and quality characteristics. Our study therefore provides evidence on PDGM’s likely effects on HHA reimbursements assuming current patient populations and service levels do not change. We find that PDGM will likely increase payments to rural and facility-based HHAs, as well as HHAs serving greater proportions of non-white, dual-eligible, and seriously ill patients. Payments will also increase for HHAs scoring higher on quality surveys, but decrease for HHAs with higher outcome and process quality scores. We also use ordinary least squares regression to examine residual variation in HHAs’ expected reimbursement changes under PDGM, after accounting for any expected changes related to their pre-PDGM levels of therapy provision. We find that larger and rural HHAs will likely experience residual payment increases under PDGM, as will HHAs with greater numbers of seriously ill, younger, and non-white patients. HHAs with higher process quality, but lower outcome quality, will similarly benefit from PDGM. Understanding how PDGM affects HHAs is crucial as policymakers seek ways to increase equitable access to safe and affordable non-facility-provided healthcare that provides appropriate levels of therapy, nursing, and other care.


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