PALLIATIVE MEDICINE - BEYOND ADVANCED CANCER CARE
Abstract
Nowadays, medicine has the same value and meaning, and is answerable to the same formidable requirements it has always been. Medicine must soothe, heal, prevent and limit the spread of disease. A physician has the opportunity to live inspiring moments while brings the very sick patients again to life and these rare moments will uplift him in the most difficult situations. In some specialties, such moments could repeat more often as in surgery, emergency medicine and sometimes in cardiology or neurology. In the majority of time, the practicing physician has to deal with chronic diseases, some of them which aggravate and complicate itself, ultimately conducting to organ failures and a very poor quality of life. Moreover, due to the success of medicine in preventing some diseases, in treatment of infectious diseases and in effective treatment of ischemic heart disease, diabetes mellitus etc. people live much longer, and experience new problems related to advanced age (1). Death, the termination of life is seen as a disease and drained by any spiritual meaning. Twenty-one century medicine is dealing with termination of life problems, with the emerging “assisted suicide” solution for the difficulties related to advanced diseases and advanced age and with a huge pressure on health system done by chronic advanced diseases with low quality of life and disability (2). New rules, new laws, new concepts are required to respond to new approaches and needs. A different health system organization is needed.
References
2. Dieudonné-Rahm N, Burkhardt S, Pautex S. In-hospital care prior to assisted and unassisted suicide in Swiss older people: a state-level retrospective study. BMC Geriatr 2019; 19(1): 300 / doi: 10.1186/ s12877-019-1325-6.
3. Baumgartner K, Cooper J, Smith A, St Louis J. Liver Disease: Cirrhosis. FP Essent 2021; 511: 36-43.
4. Rakoski MO, Volk ML. Palliative care and end-stage liver disease: a critical review of current knowledge. Curr Opin Gastroenterol 2019; 35(3): 155-160 / doi: 10.1097/MOG. 0000000000000530.
5. Peng Y, Qi X, Guo X. Child-Pugh versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies. Medicine (Baltimore) 2016; 95(8): e2877 / doi: 10.1097/MD.0000000000002877.
6. Ruf A, Dirchwolf M, Freeman RB. From Child-Pugh to MELD score and beyond: Taking a walk down memory lane. Ann Hepatol 2022; 27(1): 100535 / doi: 10.1016/j.aohep. 2021.100535.
7. Sanchez W, Talwalkar JA. Palliative care for patients with end-stage liver disease ineligible for liver transplantation. Gastroenterol Clin North Am 2006; 35(1): 201-219 / doi: 10.1016/ j.gtc.2005.12.007.
8. Walling AM, Wenger NS. Palliative care and end-stage liver disease. Clin Gastroenterol Hepatol. 2014; 12(4): 699-700 / doi: 10.1016/j.cgh.2013.11.010.
9. Larson AM. Palliative care for patients with end-stage liver disease. Curr Gastroenterol Rep 2015; 17(5): 440 / doi: 10.1007/s11894-015-0440-6.
10. Seraj SM, Campbell EJ, Argyropoulos SK, Wegermann K, Chung RT, Richter JM. Hospital readmis-sions in decompensated cirrhotics: Factors pointing toward a prevention strategy. World J Gastroen-terol 2017; 23(37): 6868-6876 / doi: 10.3748/wjg.v23. i37.6868.
11. Trifan A, Minea H, Rotaru A, et al. Predictive Factors for the Prognosis of Alcoholic Liver Cirrhosis. Medicina (Kaunas) 2022; 58(12): 1859 / doi: 10.3390/medicina58121859.
12. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommen-dation: The 2022 update. J Hepatol 2022; 76(3): 681-693 / doi: 10.1016/ j.jhep. 2021.11.018.

COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form