MedWorm: Palliative Care

Integrating Spiritual Care within Palliative Care: An Overview of Nine Demonstration Projects

Journal of Palliative Medicine — Sat, 04 Feb 2012 04:09:13 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Improving Access to Palliative Care through an Innovative Quality Improvement Initiative: An Opportunity for Pay-for-Performance

Journal of Palliative Medicine — Fri, 03 Feb 2012 14:54:19 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Factors influencing survival in patients undergoing palliative bypass for pancreatic adenocarcinoma

Journal of Surgical Oncology — Fri, 03 Feb 2012 05:00:00 +0100

ConclusionsIn a cohort of patients undergoing a palliative bypass procedure, specific peri‐operative factors can be used to identify patients who are at risk of early mortality. These factors may be helpful in selecting appropriate interventions for this group of patients. J. Surg. Oncol © 2012 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Gemcitabine and docetaxel (GEMDOX) for the treatment of relapsed and refractory pediatric sarcomas

Pediatric Blood and Cancer — Thu, 02 Feb 2012 05:00:00 +0100

ConclusionsThe dismal outcomes for patients with relapsed and refractory sarcomas and the lack of effective sarcoma salvage regimens highlight the need for new approaches. This report of the therapeutic activity of gemcitabine and docetaxel (GEMDOX) in rhabdomyosarcoma and other pediatric reports describing activity in osteosarcoma and Ewing sarcoma suggest that this combination should be considered for formal evaluation in a pediatric specific clinical trial. At a minimum, it appears to offer a reasonable, tolerable, palliative option. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults.

Pain Physician — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. PMID: 22302457 [PubMed - as supplied by publisher] (Source: Pain Physician)

Wound outcomes in patients with advanced illness

International Wound Journal — Wed, 01 Feb 2012 05:00:00 +0100

A prospective case series was studied to assess the potential for complete healing of wounds among patients with advanced illness referred to a regional palliative care program in Toronto, Canada. Two hundred and eighty‐two patients, of which 148 were primarily diagnosed with cancer and 134 with non cancer advanced illness, were assessed and followed until their deaths. On the baseline initial referral date, 823 wounds were documented. The wound classes assessed included pressure ulcers, malignant wounds, skin tears, venous leg ulcers, diabetic foot ulcers and arterial leg/foot ulcers. Proportions of patients showing complete healing of at least one wound were calculated, stratified by patient's survival time post‐baseline (1 week, 1 month, 3 months and 6 months). Proportions of patien...

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Pediatric Analgesic Clinical Trial Designs, Measures, and Extrapolation: Report of an FDA Scientific Workshop

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

Analgesic trials pose unique scientific, ethical, and practical challenges in pediatrics. Participants in a scientific workshop sponsored by the US Food and Drug Administration developed consensus on aspects of pediatric analgesic clinical trial design. The standard parallel-placebo analgesic trial design commonly used for adults has ethical and practical difficulties in pediatrics, due to the likelihood of subjects experiencing pain for extended periods of time. Immediate-rescue designs using opioid-sparing, rather than pain scores, as a primary outcome measure have been successfully used in pediatric analgesic efficacy trials. These designs maintain some of the scientific benefits of blinding, with some ethical and practical advantages over traditional designs. Preferred outcome measures...

Biliary stenting: Indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline

Endoscopy — Wed, 01 Feb 2012 05:00:00 +0100

This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy about endoscopic biliary stenting. The present Clinical Guideline describes short-term and long-term results of biliary stenting depending on indications and stent models; it makes recommendations on when, how, and with which stent to perform biliary drainage in most common clinical settings, including in patients with a potentially resectable malignant biliary obstruction and in those who require palliative drainage of common bile duct or hilar strictures. Treatment of benign conditions (strictures related to chronic pancreatitis, liver transplantation, or cholecystectomy, and leaks and failed biliary stone extraction) and management of complications (includ...

Intracerebroventricular opioids for intractable pain

British Journal of Clinical Pharmacology — Wed, 01 Feb 2012 05:00:00 +0100

SummaryAims: When pain is refractory to systemic opioid and nonopioid analgesic therapy and palliative chemoradiation or ablative or stimulant neurosurgical procedures are not possible, palliative treatment becomes limited, particularly if the patient wishes to be at home at the end of life. Intracerebroventricular (ICV) infusion of morphine in the home setting might be presented as an option. The present article reviews the basic and clinical evidence of the efficacy and safety of ICV administration of opioids. Information was gathered from various bibliographic sources, including PubMed and others, and summarized and evaluated to assess the efficacy and safety of ICV opioids for pain relief. Results from ICV infusion of morphine into terminally‐ill patients refractory to other pain ...

[Palliative care in the light of legal and regulatory requirements in Germany].

Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz — Wed, 01 Feb 2012 05:00:00 +0100

Authors: Cremer-Schaeffer P, Radbruch L Abstract In Germany, palliative care has developed rapidly since the establishment of the first palliative care unit in 1983. More improvements in patient-centered care are only possible if legal requirements as well as education of physicians, nurses, and other professionals involved in palliative care are adapted to current needs. This paper provides an overview of legal and regulatory requirements including a critical appreciation of their influence on palliative care in Germany. Only recently has medical education in palliative medicine been implemented as an integral part of medical studies at German universities. Starting in 2014, physicians applying for a license to practice medicine will have to provide a certificate of basic training...

[Review] Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. (Source: The Lancet Oncology)

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Opportunities And Challenges Of Palliative Care In The ICU Discussed In Expert Roundtable

Health News from Medical News Today — Tue, 31 Jan 2012 11:00:00 +0100

If you think palliative care and the ICU don't go together, think again. The importance and potential benefits of palliative care to ease suffering and improve quality of life for patients being treated in hospital intensive care units (ICUs) has received increasing recognition but is not without significant challenges, as discussed in a Roundtable discussion in Journal of Palliative Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc... (Source: Health News from Medical News Today)

Wrong Medicine: Doctors, Patients, and Futile Treatment [Book and Media Reviews]

JAMA — Tue, 31 Jan 2012 05:00:00 +0100

(Source: JAMA)

A Better Option for Patients With TGA/VSD and Severe Pulmonary Hypertension Undergoing Palliative Arterial Switch Operation.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:15:47 +0100

Authors: Lui RC, Zhuang J, Lei BF PMID: 22269750 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Life-affirming tales of a hospice

The Irish Times - Health — Tue, 31 Jan 2012 00:17:35 +0100

Hospices are too often associated with immense sadness, but a new series hopes to show the positive side of palliative care, writesBRIAN O'CONNELL (Source: The Irish Times - Health)

Opportunities and challenges of palliative care in the ICU discussed in expert roundtable

EurekAlert! - Social and Behavioral Science — Mon, 30 Jan 2012 05:00:00 +0100

(Mary Ann Liebert, Inc./Genetic Engineering News) If you think palliative care and the ICU don't go together, think again. The importance and potential benefits of palliative care to ease suffering and improve quality of life for patients being treated in hospital intensive care units has received increasing recognition but is not without significant challenges, as discussed in a Roundtable discussion in Journal of Palliative Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc. (Source: EurekAlert! - Social and Behavioral Science)

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Living and dying well with end‐stage liver disease: Time for palliative care?

Hepatology — Mon, 30 Jan 2012 05:00:00 +0100

(Source: Hepatology)

Neurolytic transversus abdominis plane block in the palliative treatment of intractable abdominal wall pain

Journal of Clinical Anesthesia — Sun, 29 Jan 2012 12:15:49 +0100

Abstract: A 45 year old man with metastatic colon cancer presented with uncontrollable abdominal wall pain. Transversus abdominis plane (TAP) block with ropivacaine and methylprednisolone was performed with excellent pain relief, which allowed a significant weaning of the patient's opioid requirements. A second TAP block was performed with a 33% ethanol solution (ethanol and ropivacaine) with excellent pain relief. The neurolytic block appeared to offer better pain control for more than 5 days after placement until the patient finally succumbed to his illness. (Source: Journal of Clinical Anesthesia)

Adapted ice cream as a nutritional supplement in cancer patients: impact on quality of life and nutritional status

Clinical and Translational Oncology — Sat, 28 Jan 2012 16:53:16 +0100

Conclusions The administration of ice cream could cover, in part, the social aspect of food and improve QLQ in malnourished cancer patients. These results are encouraging and deserve further confirmation. Content Type Journal ArticleCategory Research ArticlesPages 66-72DOI 10.1007/s12094-012-0763-9Authors Francesc Casas, Department of Radiation Oncology, Hospital Clinic de Barcelona, IDIBAPS, C/Villarroel, 170, ES-08036 Barcelona, SpainConcha León, Psycho-Oncology Service, Institut Oncològic del Vallès (IOV, Consorci Sanitari de Terrassa), Terrassa, Barcelona, SpainEsther Jovell, Research Service, Consorci Sanitari de Terrassa, Terrassa, Barcelona, SpainJoana Gómez, Medical Oncology Nursing Department, Institut Oncològic del Vallès (IOV, Consorci Sanitari de Te...

Predicting compliance and survival in palliative whole-brain radiotherapy for brain metastases

Clinical and Translational Oncology — Sat, 28 Jan 2012 16:53:15 +0100

Conclusions Results suggest that the geriatric tools analysed could offer information on brain palliative radiotherapy complementary to that offered by the more usual tools. It will be interesting to study if our data could be extrapolated to the general palliative oncological field. Content Type Journal ArticleCategory Research ArticlesPages 43-49DOI 10.1007/s12094-012-0760-zAuthors Sebastià Sabater, Department of Radiation Oncology, Complejo Hospitalario Universitario, C/Hermanos Falcó, 37, ES-02006 Albacete, SpainEncarna Mur, Department of Radiation Oncology, Sant Joan University Hospital, Reus, Tarragona, SpainKatrin Müller, Department of Radiation Oncology, Sant Joan University Hospital, Reus, Tarragona, SpainMeritxell Arenas, Department of Radiation Oncolog...

Authors' reply

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Andrea Tendas, Luca Cupelli, Laura Scaramucci, Massimiliano Palombi, Malgorzata Monika Trawinska, Marco Giovannini, Gregorio Antonio Brunetti, Claudio Cartoni, Francesco Bondanini, Paolo de Fabritiis, Pasquale NiscolaIndian Journal of Palliative Care 2011 17(3):260-260 (Source: Indian Journal of Palliative Care)

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Anticoagulants and anti-platelet agents in palliative home healthcare

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Viroj WiwanitkitIndian Journal of Palliative Care 2011 17(3):260-260 (Source: Indian Journal of Palliative Care)

Managing pressures ulcers in a resource constrained situation: A holistic approach

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Abhijit Dam, Nivedita Datta, Usha Rani Mohanty, Chandreyi BandhopadhyayIndian Journal of Palliative Care 2011 17(3):255-259Managing pressure ulcers remain a challenge and call for a multidisciplinary team approach to care. Even more daunting is the management of such patients in remote locations and in resource constrained situations. The management of pressure sores in a patient with progressive muscular atrophy has been discussed using resources that were locally available, accessible, and affordable. Community participation was encouraged. A holistic approach to care was adopted. (Source: Indian Journal of Palliative Care)

Dexmedetomidine infusion to facilitate opioid detoxification and withdrawal in a patient with chronic opioid abuse

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Surjya Prasad Upadhyay, Piyush Narayan Mallick, Waleed Mohamed Elmatite, Manish Jagia, Salah TaqiIndian Journal of Palliative Care 2011 17(3):251-254Many patients are admitted to the intensive care unit (ICU) for acute intoxication, serious complication of overdose, or withdrawal symptoms of illicit drugs. An acute withdrawal of drugs with addiction potential is associated with a sympathetic overactivity leading to marked psychomimetic disturbances. Acute intoxication or withdrawal of such drugs is often associated with life-threatening complications which require ICU admission and necessitate prolonged sedative analgesic medications, weaning from which is often complicated by withdrawal and other psychomimetic symptoms. Dexmedetomidine, an alpha-2 (α2 ) agonist, has been used ...

Providing Palliative Care for a dying teen at home: Perspectives and challenges

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Malathi Nayak, Naveen SalinsIndian Journal of Palliative Care 2011 17(3):248-250Adolescents and young adults with cancer are a heterogeneous group. Management of this special group requires a broad-based interdisciplinary clinical team, which should include palliative care (PC), psychology, social work, oncology, and nursing representatives. The function of PC is to provide impeccable pain and other symptom control and to coordinate care as the disease progresses. The cure rate of cancer in adolescents is high but between 10% and 40% of them will develop incurable disease depending on tumor type and prognostic factors. PC in adolescents should also take care of the specific physical and psychosocial developmental changes in this age group. A 16-year old boy suffered with incu...

Neuropathic pain due to fibromatosis: Does anticancer treatment help?

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

We report a patient with desmoid fibromatosis of the chest wall causing brachial plexus infiltration. As the tumor was locally invasive and unresectable, he was treated with radiation therapy and oral tamoxifen. On follow-up, there was significant pain relief, sustained reduction in the tumor size, and reduced analgesic requirement. Antineoplastic treatments like local radiation therapy and targeted systemic therapy with hormones or other agents can be considered in the management of selected unresectable desmoid fibromatosis to improve symptom control and reduce polypharmacy. (Source: Indian Journal of Palliative Care)

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Palliative and Supportive Care in Acrometastasis to the Hand: Case Series

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Narendra Kumar, Ritesh Kumar, Anjan Bera, Pankaj Kumar, Shabab L Angurana, Sushmita Ghosal, Radhika Srinivasan, Suresh Chander SharmaIndian Journal of Palliative Care 2011 17(3):241-244Acrometastasis to the hand is an unusual presentation which might mimic an infectious, inflammatory, or a metabolic pathology. We herein describe a case series of three patients of acrometastasis to the hand. We encountered three cases of acrometastasis to the hand attending the departmental clinics from 2007 to 2010. The median age at presentation was noted to be 55 years. All were males. The primaries included squamous cell carcinoma of the skin, larynx, and esophagus. In two patients, acrometastasis was detected at presentation and in one it was detected 2 years postcompletion of radical therapy. Two pati...

Speech and swallowing outcomes in buccal mucosa carcinoma

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Sunila John, Rashida M Hassuji, B RajashekharIndian Journal of Palliative Care 2011 17(3):238-240Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs) in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carc...

Pattern of referral of noncancer patients to palliative care in the Eastern province of Saudi Arabia

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusions : These findings suggest that the PC needs of noncancer patients are largely unmet in our region. Further efforts are necessary to advance noncancer PC in Saudi Arabia. The PC needs of patients with SCD and PAD need to be addressed in future research. (Source: Indian Journal of Palliative Care)

Attitudes and beliefs about chronic pain among nurses- biomedical or behavioral? A cross-sectional survey

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusions: Nurses had a greater orientation toward the biomedical dimension of chronic pain than the behavioral dimension. This difference was more pronounced in female nurses and those nurses who reported "very good" general health had higher behavioral dimension scores than those who had "good" general health. The study findings have important curricular implications for nurses and practical implications in palliative care. (Source: Indian Journal of Palliative Care)

Opioid-prescribing practices in chronic cancer pain in a tertiary care pain clinic

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusion: This study shows that the under treatment of pain and under dosing of opioids coupled with improper side effect management are major issues. (Source: Indian Journal of Palliative Care)

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Hypofractionated radiotherapy as local hemostatic agent in advanced cancer

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusion : Of 25 patients, 22 (88%) responded, and there was complete cessation of bleeding. Both 15 Gray and 20 Gray dose schedule had equal efficacy. Treatment was well tolerated without any intermission. Radiotherapy is a safe and effective option in controlling tumor bleeding. (Source: Indian Journal of Palliative Care)

A randomized controlled trial to compare the efficacy of bisphosphonates in the management of painful bone metastasis

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusion: The use of bisphosphonates for 6 months or more results in a statistical significant improvement in bone pain, more so with zoledronic acid. Hypercalcemia, an SRE, was significantly less in the zoledronic acid arm. (Source: Indian Journal of Palliative Care)

Reporting of pediatric palliative care: A systematic review and quantitative analysis of research publications in palliative care journals

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusions: The overall reporting rate for pediatric palliative care articles in palliative care journals was very low and there were no randomized clinical trials and systematic reviews found. The study findings indicate a lack of adequate evidence base for pediatric palliative care. (Source: Indian Journal of Palliative Care)

Attitudes toward euthanasia among doctors in a tertiary care hospital in South India: A cross sectional study

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia. (Source: Indian Journal of Palliative Care)

What does the informal caregiver of a terminally ill cancer patient need? A study from a cancer centre

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusions: informal caregivers provide most of the nursing and psychological support to the patient. However, palliative care services need to recognize that the caregiver too may need psychological and technical support. (Source: Indian Journal of Palliative Care)

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Quality of life in cancer patients with disfigurement due to cancer and its treatments

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Conclusion: Living with a disfiguring body which is visibly different is not always easy. A sudden change either due to cancer or its treatment or due to side effects leads to significant social maladjustment, elevated anxiety, depression, and poor quality of life among the cancer survivors with body disfigurement which calls for multiprofessional involvement in addressing various psychosocial issues. (Source: Indian Journal of Palliative Care)

Pain in blood cancers

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Pasquale Niscola, Andrea Tendas, Laura Scaramucci, Marco Giovannini, Vitaliana De SanctisIndian Journal of Palliative Care 2011 17(3):175-183Patients with blood-related cancers (BRC) suffer from a substantial symptom burden, including several pain syndromes sustained by different causes and pathogenetic mechanisms. So, with regard to pain, a multifaceted clinical scenario may be observed in this setting. Indeed, pain may be correlated to disease itself, to disease-associated complications, to iatrogenic causes or may be due to unrelated clinical conditions. A close diagnostic procedure for the assessment of the underlying causes of the pain and of its pathogenetic mechanisms may direct the treatment approach which should be based on a multidisciplinary management and requires the integrati...

Palliative care of young adults: An issue which needs higher and better awareness

Indian Journal of Palliative Care — Sat, 28 Jan 2012 05:00:00 +0100

Sushma Bhatnagar, Saurabh JoshiIndian Journal of Palliative Care 2011 17(3):173-174 (Source: Indian Journal of Palliative Care)

Withdrawal of Invasive Home Mechanical Ventilation in Patients with Advanced Amyotrophic Lateral Sclerosis: Ten Years of Danish Experience

Journal of Palliative Medicine — Sat, 28 Jan 2012 04:13:01 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Family's Difficulty Scale in End-of-Life Home Care: A New Measure of the Family's Difficulties in Caring for Patients with Cancer at the End of Life at Home from Bereaved Family's Perspective

Journal of Palliative Medicine — Fri, 27 Jan 2012 16:41:00 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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The Factors Associated with the Quality of Life of the Spouse Caregivers of Patients with Cancer: A Cross-Sectional Study

Journal of Palliative Medicine — Fri, 27 Jan 2012 15:31:52 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

The Palliative Prognostic Index for the Prediction of Survival and In-Hospital Mortality of Patients with Advanced Cancer in Kuwait

Journal of Palliative Medicine — Fri, 27 Jan 2012 14:29:13 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Editorial: Safer prescribing for prisoners

NeLM - News — Fri, 27 Jan 2012 05:00:00 +0100

Source: BMJ Area: News The author of this editorial discusses the recently published guideline on prescribing in prisons from the Royal College of General Practitioners (RCGP) and the Royal Pharmaceutical Society (RPS). He welcomes the guideline, however, also identifies areas which could have been further expanded on or given more attention, for example, the author notes that the guidelines "offer no advice on palliative care". (Source: NeLM - News)

Effect of Early Palliative Care on Chemotherapy Use and End-of-Life Care in Patients With Metastatic Non-Small-Cell Lung Cancer [Palliative and Supportive Care]

Journal of Clinical Oncology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusion Although patients with metastatic NSCLC received similar numbers of chemotherapy regimens in the sample, early palliative care optimized the timing of final chemotherapy administration and transition to hospice services, key measures of quality end-of-life care. (Source: Journal of Clinical Oncology)

It Takes a Village [EDITORIALS]

Journal of Clinical Oncology — Fri, 27 Jan 2012 05:00:00 +0100

(Source: Journal of Clinical Oncology)

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Massage in Supportive Cancer Care

Seminars in Oncology Nursing — Fri, 27 Jan 2012 02:56:03 +0100

Conclusion: The massage profession and the disciplines of clinical oncology have experienced a rapprochement in recent decades over questions of safety and efficacy. However, there is now significant recognition of the potential contributions of massage in supportive care, as well as greater understanding of the modifications needed in offering massage to cancer patients.Implications for Nursing Practice: Massage offers significant potential for benefiting quality of life when applied with proper understanding of the adaptations needed to accommodate the needs and vulnerabilities of cancer patients. (Source: Seminars in Oncology Nursing)

Palliative Care in the ICU

Journal of Palliative Medicine — Thu, 26 Jan 2012 14:34:55 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Evaluation of prognostic factors and the role of chemotherapy in unfavorable carcinoma of unknown primary site: A 10-year cohort study

BMC Research Notes — Thu, 26 Jan 2012 05:00:00 +0100

Conclusions: Certain patients with unfavorable CUP will have better survival. Identification of patients with unfavorable CUP who could benefit from palliative chemotherapy warrants future prospective studies. (Source: BMC Research Notes)

Management of Myeloproliferative Neoplasms: From Academic Guidelines to Clinical Practice

Current Hematologic Malignancy Reports — Wed, 25 Jan 2012 18:05:35 +0100

Abstract Myeloproliferative neoplasms (MPNs) are clonal disorders characterized by excessive production of mature cells. In most of the classic Philadelphia-negative MPNs—polycythemia vera (PV), essential thrombocythemia (ET), and MPN-associated myelofibrosis (MPN-MF)—oncogenic mutations affecting JAK2 or MPL lead to constitutive activation of cytokine-regulated intracellular signalling pathways. The traditional therapy for PV and ET is the prevention of thrombotic events with antiproliferative agents in association with aspirin. New drugs such as pegylated interferon and anti-JAK agents are candidates for slowing the evolution to myelofibrosis or leukemia. Conventional therapy for MPN-MF is driven by clinical needs, primarily anemia and splenomegaly. Lenalidomide and ...

Preferred place of care and place of death of the general public and cancer patients in Japan

Supportive Care in Cancer — Tue, 24 Jan 2012 07:34:11 +0100

In conclusion, establishing more accessible home and hospice service is strongly required through arranging regional resources to reduce family burden, alleviating patient-perceived burdens, and improving 24-h support at home. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00520-011-1373-8Authors Akemi Yamagishi, Department of Nursing, Seirei Christopher University, 3453 Mikatahara, Kita-ku, Hamamatsu, Shizuoka 433-8558, JapanTatsuya Morita, Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, JapanMitsunori Miyashita, Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, JapanSaran Yoshida, Department of Clinical Psycholo...

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Considerations in developing and delivering a non-pharmacological intervention for symptom management in lung cancer: the views of health care professionals

Supportive Care in Cancer — Tue, 24 Jan 2012 07:34:11 +0100

Discussion The participants agreed that the novel symptom management NPI should be individually personalised to the needs of each patient and be available for patients when they become receptive to it. Moreover, they agreed that the intervention would be most effective if delivered to patients individually rather than in groups, outside acute medical settings where possible and closer to patient’s homes, should be delivered by an HCP rather than a trained volunteer or lay person and should involve informal carers wherever practicable. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00520-011-1362-yAuthors Richard Wagland, Faculty of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UKJackie Ellis, Academic P...

Survival Benefit Associated With Surgical Oophorectomy in Patients With Colorectal Cancer Metastatic to the Ovary.

Clinical Colorectal Cancer — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSIONS: This retrospective analysis suggests that women with metastatic colorectal cancer metastatic to the ovary may derive a survival benefit from palliative oophorectomy. PMID: 22280844 [PubMed - as supplied by publisher] (Source: Clinical Colorectal Cancer)

New Target Therapies for Brain Metastases from Breast Cancer.

Current Cancer Drug Targets — Tue, 24 Jan 2012 05:00:00 +0100

Authors: Metro G, Fabi A Abstract Central nervous system (CNS) metastases from breast cancer (BC) represent an important cause of disease-related morbidity and mortality. For BC patients who develop CNS metastases, local control measures (both surgery and radiation) are essentially palliative and usually poorly effective, with systemic therapies often failing to achieve optimal control mainly due to the presence of the blood-brain barrier which hampers adequate penetration of therapeutic agents into the brain. However, recent evidence suggests that the status of the human epidermal growth factor receptor-2 (HER2) strongly influences the incidence of CNS metastases and the survival of BC patients from the time of development of CNS metastases, with HER2-positive (HER2+) patients gen...

The labelling and reporting of euthanasia by Belgian physicians: a study of hypothetical cases

The European Journal of Public Health — Tue, 24 Jan 2012 05:00:00 +0100

Conclusion: There is no consensus among physicians about the labelling of euthanasia and other ELDs, and about which cases must be reported. Mislabelling of ELDs could impede societal control over euthanasia. The provision of better information to physicians appears to be necessary. (Source: The European Journal of Public Health)

Metronomic chemotherapy in advanced oral cancers

Journal of Cancer Research and Therapeutics — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions: Use of metronomic chemotherapy seems promising and well tolerated in this setting. Large trials are warranted to confirm these results. (Source: Journal of Cancer Research and Therapeutics)

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Metastatic angiosarcomas: doxorubicin-based regimens, weekly paclitaxel and metastasectomy significantly improve the outcome

Annals of Oncology — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions: This retrospective analysis indicates that some therapeutic interventions may significantly improve the outcome of this aggressive disease. Doxorubicin-based regimens and weekly paclitaxel seem to provide the same range of efficacy. (Source: Annals of Oncology)

Lung cancer physicians' referral practices for palliative care consultation

Annals of Oncology — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions: Although palliative care consultation is increasingly available and recommended throughout the trajectory of lung cancer, our data indicate it is underutilized. Understanding factors influencing decisions to refer can be used to improve integration of palliative care as part of lung cancer management. (Source: Annals of Oncology)

A Better Option for Patients With TGA/VSD and Severe Pulmonary Hypertension Undergoing Palliative Arterial Switch Operation [CORRESPONDENCE]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

(Source: The Annals of Thoracic Surgery)

Hospice and Palliative Medicine: Curriculum Evaluation and Learner Assessment in Medical Education

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:48 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 116-122. (Source: Journal of Palliative Medicine)

Next Gen Palliative Care

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:38 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 2-4. (Source: Journal of Palliative Medicine)

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Dyspnea Review for the Palliative Care Professional: Treatment Goals and Therapeutic Options

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:35 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 106-114. (Source: Journal of Palliative Medicine)

Reflections on a Coral Tree: My Palliative Fellowship Year

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:24 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 131-133. (Source: Journal of Palliative Medicine)

Dying in U.S. Nursing Homes with Advanced Dementia: How Does Health Care Use Differ for Residents with, versus without, End-of-Life Medicare Skilled Nursing Facility Care?

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:22 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 43-50. (Source: Journal of Palliative Medicine)

The Medical Legal Partnership: Addressing Medical-Legal Suffering for Patients with Advanced Illness #245

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:16 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 123-124. (Source: Journal of Palliative Medicine)

Insomnia: Patient Assessment #101

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:15 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 124-126. (Source: Journal of Palliative Medicine)

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Palliative Care and Obesity: Are We Prepared?

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:13 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 7-8. (Source: Journal of Palliative Medicine)

Persons Registered for Medical Marijuana in the United States

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:12 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 9-11. (Source: Journal of Palliative Medicine)

In This Issue

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:12 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 1-1. (Source: Journal of Palliative Medicine)

Defining Refractory Pain in Cancer for Clinicians and Researchers

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:01 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 5-6. (Source: Journal of Palliative Medicine)

Discussions of Life Expectancy Moderate Relationships between Prognosis and Anxiety or Depression in Men with Advanced Cancer

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:02:00 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 99-105. (Source: Journal of Palliative Medicine)

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Truth in Hope and Hope in Truth

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:47 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 128-129. (Source: Journal of Palliative Medicine)

No Good Deed: A Story of Medicine, Murder Accusations, and the Debate Over How We Die

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:46 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 138-138. (Source: Journal of Palliative Medicine)

The Birdfeeder

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:46 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 127-127. (Source: Journal of Palliative Medicine)

Words from the Heart: A Practical Guide to Writing an Ethical Will

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:45 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 138-139. (Source: Journal of Palliative Medicine)

Recent LiteratureFeature Editor: Paul C. Rousseau

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:44 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 140-141. (Source: Journal of Palliative Medicine)

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Roulette

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:44 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 130-130. (Source: Journal of Palliative Medicine)

The Importance of Curricular Evaluation

Journal of Palliative Medicine — Mon, 23 Jan 2012 21:01:43 +0100

Journal of Palliative Medicine Jan 2012, Vol. 15, No. 1: 115-115. (Source: Journal of Palliative Medicine)

Scales for the Evaluation of End-of-Life Care in Advanced Dementia: Sensitivity to Change

Alzheimer Disease and Associated Disorders — Mon, 23 Jan 2012 06:00:00 +0100

This study extends the psychometric properties of the EOLD scales by showing the sensitivity to clinically meaningful change in these scales to specific outcomes related to end-of-life care and quality of life among residents with end-stage advanced dementia and their HCPs. (C) 2012 Lippincott Williams & Wilkins, Inc. (Source: Alzheimer Disease and Associated Disorders)

No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in (term) labour

Evidence-Based Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Context Wassen and colleagues have published an article on a topic of great practical importance: Does epidural analgesia (EA) given early in labour (≤3 cm cervical dilatation) increase the risk of instrumental delivery, compared with EA administered later in labour? This is important because EA is the most effective labour analgesia, and, if the timing of its administration is not associated with any adverse consequences, then it should not be denied to women in early labour. Women who have EA during their labour, compared with women who have other forms of analgesia, are at increased risk of instrumental delivery (RR 1.38, 95% CI 1.24 to 1.53).1 Instrumental deliveries are associated with increased risks to women of vaginal/perineal trauma and anal sphincter damage, which may in turn ...

Elmo's Story [Commentary]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

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Palliative care focuses on pain relief and quality of care

MayoClinic.com Full Feed — Sat, 21 Jan 2012 06:00:00 +0100

Palliative care addresses physical, emotional and spiritual needs of a person with a serious or life-threatening illness. (Source: MayoClinic.com Full Feed)

Choosing To Die At Home In The UK

Health News from Medical News Today — Fri, 20 Jan 2012 09:00:00 +0100

Although around two thirds of us would prefer to die at home, in the developed world the trend in recent years has been for the majority to spend their final days in an institutional setting. But according to new research available in the journal Palliative Medicine, published by SAGE and from King's College London, the tide has now turned and an increasing number of people in the UK are dying at home. In England and Wales, the number of deaths at home nearly halved from 1974 to 2003. If this trend continued, researchers projected that fewer than one in ten would die at home by 2030... (Source: Health News from Medical News Today)

Is cardiac resynchronisation therapy better than right ventricular pacing after atrioventricular junction ablation for medically refractory atrial fibrillation?

Heart — Fri, 20 Jan 2012 05:00:00 +0100

Despite improvements in our understanding of the mechanisms underlying atrial fibrillation (AF) and significant advancements in the treatment options available, optimal management and symptom relief remains a challenge in some patients. In patients with medically refractory AF more aggressive measures may be required, including percutaneous catheter ablation (pulmonary vein isolation, with or without additional substrate modification) or atrioventricular (AV) junction ablation with concomitant insertion of a permanent pacemaker. The latter option, widely known as an ‘ablate and pace’ strategy, may be preferable in patients who want a definitive, albeit palliative, treatment of their symptoms and are not willing to take the risks and potential recurrences associated with AF abla...

Intracranial Metastatic Neuroblastoma Treated with Gamma Knife Stereotactic Radiosurgery: Report of Two Novel Cases

Journal of Nanomaterials — Thu, 19 Jan 2012 15:27:25 +0100

We present two patients with IMN treated with Gamma Knife stereotactic radiosurgery (SRS). Single-fraction radiotherapy yielded temporary reduction of tumor burden and stability of disease in both patients. SRS may be a useful palliative tool in the treatment of IMN and expands the overall treatment options for this disease. (Source: Journal of Nanomaterials)

Venous Air Embolism Leading to Cardiac Arrest in an Infant with Cyanotic Congenital Heart Disease

Journal of Nanomaterials — Thu, 19 Jan 2012 15:27:25 +0100

We present a case of gas embolism occurring in the immediate postoperative period in an infant with cyanotic congenital heart disease after palliative cardiac surgery resulting in cardiopulmonary arrest. The embolism was diagnosed by visualization of air within the vessel creating an airlock and occluding pulmonary blood flow. (Source: Journal of Nanomaterials)

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Creation of a questionnaire to measure stress among nurses engaged in palliative care on general wards

Supportive Care in Cancer — Thu, 19 Jan 2012 06:58:40 +0100

Conclusions The questionnaire developed had high internal validity and high reliability, and it can thus serve as a first stage in elucidating stress among nurses engaged in palliative care on general wards. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00520-011-1368-5Authors Ako Terakado, Department of Comprehensive Diagnosis and Therapeutics, Section Division of Liaison Psychiatry and Palliative Medicine, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 JapanTakako Watanabe, School of Nursing, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan Journal Supportive Care in CancerOnline ISSN 1433-7339Print ISSN 0941-4355 (Source: Supportive Care in Cancer)

Symptomatic and Palliative Care for Stroke Survivors

Journal of General Internal Medicine — Thu, 19 Jan 2012 06:51:08 +0100

We present the current and established data to aid health care providers in symptomatic and palliative management of stroke survivors. Content Type Journal ArticleCategory ReviewsPages 1-8DOI 10.1007/s11606-011-1966-4Authors Claire J. Creutzfeldt, Department of Neurology, University of Washington Harborview Medical Center, Box 359775, 325 Ninth Ave, Seattle, WA 98104-2499, USARobert G. Holloway, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USAMelanie Walker, Department of Neurology, University of Washington Harborview Medical Center, Box 359775, 325 Ninth Ave, Seattle, WA 98104-2499, USA Journal Journal of General Internal MedicineOnline ISSN 1525-1497Print ISSN 0884-8734 (Source: Journal of General Internal Medicine)

SALTO: a randomized, multicenter study assessing octreotide LAR in inoperable bowel obstruction.

Bulletin du Cancer — Thu, 19 Jan 2012 05:00:00 +0100

Authors: Laval G, Rousselot H, Toussaint-Martel S, Mayer F, Terrebonne E, François E, Brixi H, Nguyen T, Bourdeix I, Bisot-Locard S, Zelek L Abstract This phase II, multicenter, randomized, double-blind, non-comparative study assessed the efficacy and safety of immediate-release octreotide and octreotide LAR, in combination with corticosteroids and standard medical care, on the symptoms of inoperable malignant bowel obstruction (MBO) due to peritoneal carcinomatosis. The primary efficacy endpoint was "success" at day 14 defined as a composite endpoint including the absence of a nasogastric tube, and vomiting less than twice per day and no use of anticholinergic agents. Patients in the octreotide arm received octreotide LAR 30 mg intramuscular (im) on days 1, 29 and 57, as w...

Airway Complications After Covered Stent Placement for Malignant Esophageal Stricture: Special Reference to Radiation Therapy

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Esophagorespiratory fistula is much more common than airway narrowing as an airway complication. The rate of complications increases significantly in association with radiation therapy among patients with malignant esophageal stricture. Clinicians need to be aware of earlier airway complications and poorer prognosis among patients who undergo radiation therapy before placement of an esophageal stent than in patients who undergo radiation after stent placement. (Source: American Journal of Roentgenology)

Percutaneous computed tomography guided cryoablation of the celiac plexus as an alternative treatment for intractable pain caused by pancreatic cancer

Journal of Cancer Research and Therapeutics — Thu, 19 Jan 2012 05:00:00 +0100

Hooman Yarmohammadi, Dean A Nakamoto, Nami Azar, Salim M Hayek, John R HaagaJournal of Cancer Research and Therapeutics 2011 7(4):481-483Computed Tomography (CT)-guided percutaneous cryoablation was performed in a 43-year-old patient with intractable epigastric abdominal pain caused by advanced adenocarcinoma of the pancreas and extensive celiac trunk involvement. Initial treatment with celiac plexus nerve neurolysis using local ethanol injection was unsuccessful. A 17-gauge 17-cm cryoablation probe (Galil Medical Inc. Plymouth Meeting, PA) was placed into the expected location of the celiac plexus through a left paraspinal approach under CT guidance and two cycles of freeze-thaw were performed. Patient's pain decreased from 10 of 10 (subjective pain scoring using a visual analog sc...

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Docetaxel and Cisplatin plus Fluorouracil compared with modified docetaxel, Cisplatin, and 5-Fluorouracil as first-line therapy for advanced gastric cancer: a retrospective analysis of single institution.

Neoplasma — Thu, 19 Jan 2012 04:30:02 +0100

In conclusion, the response rate, median PFS and median OS are similar in both arms, while the mDCF regimen are more favorable than the DCF for toxicity profile regimen in advanced gastric cancer patients who were undergoing first-line palliative treatment. Therefore, a prospective and larger clinical trials are needed. Keywords: advanced gastric cancer, docetaxel, cisplatin, fluorouracil. PMID: 22248282 [PubMed - in process] (Source: Neoplasma)

Clinical Outcomes and Health-Related Quality of Life after Thoracoscopic Talc Pleurodesis

Journal of Palliative Medicine — Thu, 19 Jan 2012 04:09:34 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Author Index