Saint Luke's Health System

About: Saint Luke's Health System is a healthcare organization based out in Kansas City, Missouri, United States. It is known for research contribution in the topics: Health care & Population. The organization has 163 authors who have published 193 publications receiving 3149 citations.

Models for structuring a clinical initiative to enhance palliative care in the intensive care unit: A report from the IPAL-ICU Project (Improving Palliative Care in the ICU)

Abstract: Objective:To describe models used in successful clinical initiatives to improve the quality of palliative care in critical care settings.Data Sources:We searched the MEDLINE database from inception to April 2010 for all English language articles using the terms “intensive care,” “critical care,” or

Prognostic Correlations and Response to Treatment in Advanced Metastatic Malignant Melanoma

Abstract: Summary Four-hundred twenty-six patients with disseminated melanoma were analyzed, all of whom were treated with chemotherapy. There was a high correlation with hepatic metastases and elevated lactic dehydrogenase levels. Although there were frequent false-positive lactic dehydrogenase levels, normal lactic dehydrogenase levels were consistently associated with a normal liver. Central nervous system disease was a major cause of morbidity and mortality in metastatic melanoma. Eleven % of the patients in this study had evidence of central nervous system disease at onset. The only treatment that was proven to be effective in these patients was whole-brain radiotherapy with concomitant dexamethasone administration. There were certain areas of anatomical involvement that correlated with an improved survival. These were patients that had pulmonary metastases only (median survival, 10 months) and patients with disease limited to the skin and s.c. tissue (median survival), 11 months). The median survival for all patients was 4.7 months. The response rate to a variety of treatment regimens with 5-(3,3-dimethyl-1-triazeno)imidazole-4-carboxamide was 18% (75 of 426) for all patients and 23% for evaluable patients only. There was an increased response to 5-(3,3-dimethyl-1-triazeno)imidiazole-4-carboxamide for nonvisceral involvement (28%), compared with visceral involvement (13%). The addition of 1,3-bis[2-chloroethyl-1-nitrosourea appeared to have an increased response rate for pulmonary and other visceral involvement, compared with 5-(3,3-dimethyl-1-triazeno)imidazole-4-carboxamide alone.

Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care.

Abstract: Objective Although successful models for palliative care delivery and quality improvement in the intensive care unit have been described, their applicability in surgical intensive care unit settings has not been fully addressed. We undertook to define specific challenges, strategies, and solutions for integration of palliative care in the surgical intensive care unit.