Medical Staff Pulse Newsletter

New Officers Elected for 2011

MEC Update

Christopher Ng, M.D., was elected for a second term as secretary of the medical staff and David Kulber, M.D., was elected as treasurer at the Dec. 6 Medical Executive Committee meeting. Also at the meeting, Chief of Staff Scott Karlan, M.D., announced that he has begun to send new Constitutional language to medical staff members for comment.

Morning After Report- December 2010

George Berci, M.D. ...

John Harold, M.D. ...

Prediman K. Shah, M.D. ...

Rick B. Delamarter, M.D. ...

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Reversal of Dabigatran's Effects

Pharmacy Focus

Dabigatran (Pradaxa®) is a new oral direct thrombin inhibitor approved in the U.S. for the prevention of stroke and systemic embolism in non-valvular atrial fibrillation patients.1 Over the past few weeks, there has been increased interest in this product and a growing number of inquiries regarding the management of these patients when anticoagulation needs to be reversed.

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Meetings and Events

The Drug Industry, Clinicians and Responsibility
Jan. 19

Advances in Nuclear Cardiology and Cardiac CT
Jan. 21-23

International Symposium on Pancreatic and Biliary Endoscopy
Jan. 28-30

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Early Palliative Care Referrals Improve Quality of Life and Life Expectancy for Lung Cancer Patients

By Linda Gorman, RN, MN, PMHCNS-BC, FPCN
Palliative Care Clinical Nurse Specialist

The palliative care world has been buzzing about a new study that demonstrates the positive impact of early referrals. This data challenges the fears that some people carry that the presence of palliative care hastens death. The recent study by JS Temel et al found that patients with metastatic non-small cell lung cancer had a number of benefits from receiving early palliative interventions which included regular appointments to address symptoms, goals and advance directives. This population is known to have a substantial symptom burden and often receives aggressive treatment at the end of life.

Patients were randomly assigned into two groups: one group received early palliative care integrated with standard oncologic care and the second group received standard oncologic care alone.

The study population with early palliative care had significant improvements in both quality of life and mood. Patient preferences regarding goals and resuscitation wishes were clearly documented and followed. This group received less aggressive care at the end of life based on patient wishes. Earlier referral to hospice was also achieved. One of the most important results was that patients receiving early palliative care intervention had median survival longer than those receiving standard oncologic treatment only (palliative care group median survival of 11.6 months vs 8.9 months).

This study reinforces the need for early palliative care referrals for patients with serious illness. It also reminds us that introducing palliative care early in the presence of advanced disease does not mean the patient has to “give up” cancer treatment. The two can co-exist. Palliative care is not synonymous with hospice.

Reference: JS Temel, et al. (2010). Early palliative Care for patients with Metastatic Non-Small-Cell Lung Cancer. New England Journal of Medicine. 363:733-42.