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  • 1
    Language: French
    In: Archives de pédiatrie, June 2012, Vol.19(6), pp.H139-H140
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0929-693X(12)71180-6 Byline: R. Cremer Author Affiliation: Reanimation pediatrique, Hopital Jeanne de Flandre, CHU de Lille, 59037, Lille. Espace Ethique hospitalier et Universitaire de Lille, 1 place de Verdun, 59045 Lille, France
    Keywords: Medicine
    ISSN: 0929-693X
    E-ISSN: 1769-664X
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  • 2
    Language: English
    In: Intensive Care Medicine, 2011, Vol.37(10), pp.1648-1655
    Description: Byline: Robin Cremer (1,2), Philippe Hubert (3,6), Bruno Grandbastien (4,7), Gregoire Moutel (5,6), Francis Leclerc (1,8) Keywords: Withdrawing treatments; Guideline adherence; Intensive care unit; Ethics; Child; Uncompensated care; Patient care management; Hospital costs Abstract: Purpose Our goal is to assess the prevalence of questioning about the appropriateness of initiating or maintaining life-sustaining treatments (LST) in French-speaking paediatric intensive care units (PICUs) and to evaluate time utilisation related to decision-making processes (DMP). Methods 18-month, multicentre, prospective, descriptive, observational study in 15 French-speaking PICUs. Results Among the 5,602 children admitted, 410 died (7.3%), including 175 after forgoing LST (42.7% of deaths). LST was questioned in 308 children (5.5%) with a prevalence of 13.3 per 100 patient-days. More than 30% of children survived despite the appropriateness of LST being questioned (23% despite a decision to forgo treatment). Median caregiver time spent on making and presenting the decisions was 11 h per child. Conclusions In this study, on any given day in each 10-bed PICU, there was more than one child for whom a DMP was underway. Of children, 23% survived despite a decision to forgo LST being made, which underlines the need to elaborate a care plan for these children. Also, DMP represented a large amount of staff time that is undervalued but necessary to ensure optimal palliative practice in PICU. Author Affiliation: (1) Reanimation Pediatrique, Hopital Jeanne de Flandre, CHU de Lille, 59037, Lille Cedex, France (2) Espace Ethique Hospitalier et Universitaire de Lille, 1 place de Verdun, 59045, Lille Cedex, France (3) Reanimation Pediatrique, Hopital Necker-Enfants Malades, Rue de Sevres, 75007, Paris, France (6) Universite Paris V - Descartes, 12 rue de l'ecole de medecine, 75006, Paris, France (4) Service d'Epidemiologie Regional, Hopital Calmette, CHU de Lille, 59037, Lille Cedex, France (7) Universite Lille Nord de France, 1 bis rue Georges Lefebvre, 59800, Lille, France (5) Reseau de Recherche en Ethique de l'INSERM, Laboratoire d'Ethique Medicale, Faculte de Medecine Paris-Descartes, 75270, Paris, France (8) Universite Lille Nord de France, UDSL, EA 2694, 1 bis rue Georges Lefebvre, 59800, Lille, France Article History: Registration Date: 09/07/2011 Received Date: 21/10/2010 Accepted Date: 12/04/2011 Online Date: 16/08/2011
    Keywords: Withdrawing treatments ; Guideline adherence ; Intensive care unit ; Ethics ; Child ; Uncompensated care ; Patient care management ; Hospital costs
    ISSN: 0342-4642
    E-ISSN: 1432-1238
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  • 3
    Language: English
    In: International Journal of Cardiology, 15 December 2017, Vol.249, pp.494-495
    Keywords: Medicine
    ISSN: 0167-5273
    E-ISSN: 1874-1754
    Source: ScienceDirect Journals (Elsevier)
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  • 4
    Language: English
    In: Archives of Disease in Childhood, 17 November 2013, Vol.98(11), p.856
    Description: Oral aversion and feeding disorders occur frequently after long-term feeding via a tube. A rapid home-based tube-weaning programme that provides feeding disorder treatment under medical supervision to overcome oral aversion has been developed.
    Keywords: Nutrition ; Child Psychology ; Infant Feeding ; Growth ; Gastroenterology
    ISSN: 0003-9888
    ISSN: 00039888
    E-ISSN: 1468-2044
    E-ISSN: 14682044
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  • 5
    Language: English
    In: Journal of the American College of Cardiology, 17 March 2015, Vol.65(10), pp.A1148-A1148
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(15)61148-2 Byline: Paul Cremer, Richard Brunken, Venu Menon, Manuel Cerqueira, Wael Jaber Author Affiliation: Cleveland Clinic, Cleveland, OH, USA Article Note: (footnote) Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: Cardiac PET Imaging Abstract Category: 19. Non Invasive Imaging: Nuclear Presentation Number: 1135-013
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 6
    Language: English
    In: Journal of the American College of Cardiology, 17 March 2015, Vol.65(10), pp.A1138-A1138
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0735-1097(15)61138-X Byline: Paul Cremer, Muhammed Tariq, Abhishek Karwa, Scott Flamm, Allan Klein, Deborah Kwon Author Affiliation: Cleveland Clinic, Cleveland, OH, USA Article Note: (footnote) Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 3:45 p.m.-4:30 p.m. Session Title: CMR in Cardiomyopathy Abstract Category: 18. Non Invasive Imaging: MR Presentation Number: 1134-003
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 7
    Language: English
    In: Journal of the American College of Cardiology, 04 October 2016, Vol.68(14), pp.1603-1604
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacc.2016.06.065 Byline: Paul C. Cremer, Wael A. Jaber Article Note: (footnote) Please note: The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 8
    Language: English
    In: Journal of the American College of Cardiology, 06 June 2017, Vol.69(22), pp.2775-2776
    Description: Dr. Brucato and colleagues raise an important issue in the nomenclature of pericardial disease: diagnoses of most patients with acute or recurrent pericarditis are labeled idiopathic. As the authors note, the term idiopathic elicits a sense of complacency among physicians. For patients, the response...
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 9
    Language: English
    In: Journal of the American College of Cardiology, 25 October 2016, Vol.68(17), pp.1925-1926
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacc.2016.06.074 Byline: Paul C. Cremer, L. Leonardo Rodriguez, Wael A. Jaber Article Note: (footnote) Please note: The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
    Keywords: Medicine
    ISSN: 0735-1097
    E-ISSN: 1558-3597
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  • 10
    Language: English
    In: The American Journal of Medicine, June 2017, Vol.130(6), pp.744.e9-744.e15
    Description: Individuals with cerebral palsy have less lean body mass, greater relative adiposity, and lower fitness and physical activity participation, and yet the prevalence of age-related multimorbidity in this population has yet to be established. The study objective was to examine the prevalence of lifestyle-related chronic conditions and multimorbidity in a sample of middle-aged adults with cerebral palsy. A clinic-based sample of middle-aged adults with cerebral palsy was examined using Electronic Medical Records Search Engine software. Our cohort included 435 individuals aged 40 to 60 years, with an International Classification of Diseases, Clinical Modification, 9th and 10th Revisions Diagnosis Code for cerebral palsy. Prevalence of 12 chronic conditions was evaluated, including existing diagnoses or historical record of osteopenia/osteoporosis, myocardial infarction, stroke, coronary artery disease, impaired glucose tolerance/type 2 diabetes, other cardiovascular conditions, rheumatoid arthritis, osteoarthritis, asthma, emphysema, prehypertension/hypertension, and hyperlipidemia. Multivariate logistic models were used to estimate multimorbidity (ie, ≥2 chronic conditions), adjusting for age, sex, smoking status, obesity, and Gross Motor Function Classification System (GMFCS). There were 137 unique multimorbidity combinations. Multimorbidity was significantly more prevalent among obese versus nonobese individuals for both GMFCS I-III (75.8% vs 53.6%) and GMFCS IV-V (79.0% vs 64.2%), but was also significantly higher in nonobese individuals with GMFCS IV-V (64.2%) compared with nonobese individuals with GMFCS I-III (53.6%). Both the obesity status (odds ratio, 2.20; 95% confidence interval, 1.32-2.79) and the GMFCS IV-V category (odds ratio, 1.81; 95% confidence interval, 1.32-3.68) were independently associated with multimorbidity. Middle-aged adults with cerebral palsy have high estimates of multimorbidity; both obesity and higher GMFCS levels are independently associated with greater risk.
    Keywords: Cerebral Palsy ; Diabetes ; Hypertension ; Multimorbidity ; Obesity ; Osteoporosis ; Medicine
    ISSN: 0002-9343
    E-ISSN: 1555-7162
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