8 ‘Tell-Tale’ Signs Associated With Impending Death In Patients With Advanced Cancer

Originally published on Forbes in February 2015.

Being able to diagnose death within several days of it happening can assist cancer patients and their families with making end-of-life care decisions. A new study seeks to help with the process by providing physicians with a list of indications to consider when evaluating a patient for impending death.

The research, released by the American Cancer Society, revealed eight bedside physical “tell-tale” signs associated with death within three days in cancer patients: non-reactive pupils, decreased response to verbal stimuli, decreased response to visual stimuli, inability to close eyelids, drooping of the nasolabial fold, hyperextension of the neck, grunting of vocal cords and upper gastrointestinal bleed.

The study analyzed the physical changes in the final days of life in 357 cancer patients who were admitted to acute palliative care units in two cancer centers: MD Anderson Cancer Center in Houston and Barretos Cancer Hospital in Brazil. The researchers documented 52 physical signs every 12 hours from admission to death or discharge. A little more than the majority of the patients died during the study.

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CVS Health Returns Unsold Tobacco to Suppliers

Originally published on cjarlotta.com in September 2014.

As CVS Caremark Corp. rebranded itself into CVS Health by going through with its decision to remove all tobacco products from store shelves, the revamped primary care services provider neglected to answer one crucial question: What’s going to happen with all of that unsold tobacco?

“All unsold tobacco inventory was returned to our suppliers,” CVS Health Public Relations Director Mike DeAngelis said in an email. “The decision to end the sale of tobacco underscores our role in the evolving health care system.”

Earlier in the month, the Woonsocket, Rhode Island-based company, known mostly for its pharmacy services, officially removed all tobacco products from the shelves of 7,700 retail pharmacies under its control.

In addition, CVS Health kicked off a personalized smoking cessation campaign to help smokers kick the habit. The campaign includes four components: an assessment of the smoker’s readiness to quit, education to give smokers the information and tools they need to quit, medication support to help curb the desire to use tobacco and coaching to help individuals stay motivated and prevent relapses.

“Cigarettes have no place in a setting where health care is delivered,” DeAngelis said. “This was the right thing to do.”

CVS Health in February announced it would stop selling tobacco products by October 1. The company at the time estimated that the decision would put a small $2 billion dent in its annual sales of $125 billion.