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Dyspnea AND palliative

Erin McKenzie, Liying Zhang, Pearl Zaki, Stephanie Chan, Vithusha Ganesh, Yasmeen Razvi, May Tsao, Elizabeth Barnes, Matthew K Hwang, Carlo DeAngelis, Edward Chow
BACKGROUND: Cancer patients often present with several concurrent symptoms. There is evidence to suggest that related symptoms can cluster together in stable groups. The present study sought to identify symptom clusters in advanced cancer patients using the Edmonton Symptom Assessment System (ESAS) in a palliative outpatient radiotherapy clinic. METHODS: Principal component analysis (PCA), exploratory factor analysis (EFA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the 9 ESAS items using ESAS scores from each patient's first visit...
September 5, 2018: Annals of Palliative Medicine
Maria Aparecida Scottini, Rachel Duarte Moritz, José Eduardo de Siqueira
OBJECTIVE: Evaluating the degree of cognition, functionality, presence of symptoms and medications prescribed for patients under palliative home care. METHOD: Descriptive, cross-sectional study where 55 patients under palliative home care were interviewed. Cognition was evaluated using the Mini-Mental state examination (MM), with patients being separated into two groups: with preserved cognitive ability (MM>24), or altered (MM <24). The functionality was verified by the Palliative Performance Scale (PPS) and the patients were divided into two groups: PPS≤50 and PPS≥60...
October 2018: Revista da Associação Médica Brasileira
Alma Alihodzic-Pasalic, Veljko Maric, Ademir Hadzismailovic, Alen Pilav, Kemal Grbic
Background: Chemical pleurodesis is generally accepted palliative dyspnea therapy and preventive of re-accumulation of pleural fluid in patients with malignant pleural effusions. Aim: Comparative analyses of efficiency of chemical pleurodesis between Video Assisted Thoracoscopic Surgery (VATS) and standard thoracostomy. Methods: From 01.01.2016-01.01.2017 at the Clinic for Thoracic Surgery of University Clinical Center (UCC) Sarajevo retrospective analysis was performed...
October 2018: Acta Informatica Medica: AIM
Erin E Stevens, Janet L Abrahm
Lesbian, gay bisexual, transgender, and queer or questioning (LGBTQ) older adults have unique health care needs, especially in the palliative care and hospice setting. In this article, we present a male patient with metastatic ovarian cancer, admitted with worsening dyspnea, now at the end of life. Only his wife was aware of his identified gender, and nondisclosure was very important to him. As he continued to decline, the team navigated LGBTQ-sensitive care within the health care setting, insurance inequalities, and support and communication to his family...
December 4, 2018: Journal of Palliative Medicine
Borna E Tabibian, Arsalaan A Salehani, Elizabeth N Kuhn, Matthew C Davis, Christopher D Shank, Winfield S Fisher Iii
BACKGROUND: Involvement of the palliative care service has potential for patient and family benefit in critically ill patients, regardless of etiology. Anecdotally, there is a lack of involvement of the palliative care (PC) service in the neuro-intensive care unit (neuro-ICU), and its impact has not been rigorously investigated in this setting. OBJECTIVE: This study aims at assessing the effect of early involvement of the PC service on end-of-life care in the neuro-ICU...
November 29, 2018: Journal of Palliative Medicine
Zhu Mei, He Wang, Shengnan Ren, Juan Wei, Yanhong Gu
RATIONALE: Thymic carcinoids are a rare type of malignant neuroendocrine tumors which have a poor prognosis due to their distant metastasis, invasive behaviour, and postoperative recurrence. Surgical resection is still the fundamental mode for treating thymic carcinoids. Here, we report the rapid shrinkage of an atypical thymic carcinoid with multiple metastases following chemoradiation plus octreotide as a first-line therapy PATIENT CONCERNS:: A 39-year-old Chinese man presented with chest tightness, dyspnea with a history of lumbago and untreated malignant thymoma...
November 2018: Medicine (Baltimore)
K Rajala, J T Lehto, E Sutinen, H Kautiainen, M Myllärniemi, T Saarto
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a chronic disease with a high symptom burden and poor survival that influences patients' health-related quality of life (HRQOL). We aimed to evaluate IPF patients' symptoms and HRQOL in a well-documented clinical cohort during their last two years of life. METHODS: In April 2015, we sent the Modified Medical Research Council Dyspnea Scale (MMRC), the modified Edmonton Symptom Assessment Scale (ESAS) and a self-rating HRQOL questionnaire (RAND-36) to 300 IPF patients, of which 247 (82%) responded...
November 20, 2018: BMC Pulmonary Medicine
Joaquim Julià-Torras, Miguel Ángel Cuervo-Pinna, Luis Cabezón-Gutiérrez, Pedro C Lara, Marisol Prats, César Margarit, Josep Porta-Sales
BACKGROUND: Episodic dyspnea is an increasingly recognized phenomenon that occurs frequently in patients with cancer. Although numerous definitions have been proposed to describe episodic dyspnea, to date, no common widely accepted definition in Spanish has yet emerged. Without a clear well-accepted definition, it is difficult to design rigorous clinical trials to evaluate candidate treatments for this emerging entity and to compare outcomes among studies. OBJECTIVE: The aim of the study was to reach a consensus definition of episodic dyspnea in the Spanish language based on professional criteria in cancer patients...
November 16, 2018: Journal of Palliative Medicine
Jiacai Cho, Jamie Zhou, Dominic Lo, Anselm Mak, Sen Hee Tay
OBJECTIVES: To determine the extent of end-of-life suffering and predictors of high symptom prevalence in the last one year of life in patients with systemic rheumatic diseases (SRDs) and the extent of supportive care received. METHODS: We identified adult patients with SRDs who died between 1 April 2006 and 1 April 2016. We collected data within 1 year before their death, on the following: (i) cumulative symptom prevalence, (ii) rates of Advance Care Planning (ACP), Do-Not-Resuscitate (DNR) orders and referral to a palliative physician...
November 2, 2018: Seminars in Arthritis and Rheumatism
Sneha Dhillon, Saurabh Bansal, Girish Sindhwani, Meenu Gupta, Vipul Nautiyal, Sunil Saini, Mushtaq Ahmad
Purpose: The aim of the study was to evaluate the short-term clinical, endoscopic response, and acute toxicities in endobronchial cancer treated with high-dose-rate endobronchial brachytherapy (HDR-EB). Materials and Methods: Thirty patients of advanced endobronchial cancers were treated with HDR-EB. Brachytherapy was delivered at a depth of 1 cm from the source axis at weeks 1, 2, and 3 with 7 Gy per fraction. All patients were evaluated before treatment and at 1 month after completion of therapy...
October 2018: South Asian Journal of Cancer
Stephanie L Stephens, J Brian Cassel, Danielle Noreika, Egidio Del Fabbro
The US population of inmates continues to increase along with a rapid escalation in the number of elderly prisoners. Previous studies have demonstrated multiple barriers to providing palliative care for seriously ill inmates. The aim of this study was to assess the frequency of palliative care consultation and nature of consultation requests for inmates who died while hospitalized at a large tertiary care hospital. A retrospective chart review of all inmate decedents over a 10-year time period was conducted...
November 14, 2018: American Journal of Hospice & Palliative Care
Yet Hong Khor, Raymond Wong, Christine F McDonald
BACKGROUND: Home oxygen therapy is commonly prescribed for patients who remain hypoxemic at hospital discharge, although evidence supporting this practice is lacking. This study aimed to evaluate oxygen prescription and follow-up for patients who were prescribed post-discharge short-term oxygen therapy (STOT) and to assess their long-term outcome. METHODS: A retrospective audit was undertaken of subjects prescribed STOT following hospitalization at a single site in Melbourne, Australia, between January 2011 and December 2015...
November 6, 2018: Respiratory Care
Qingyuan Zhuang, Grace Meijuan Yang, Shirlyn Hui-Shan Neo, Yin Bun Cheung
BACKGROUND: The prevalence and severity of dyspnea increases at the end of life. Many of these patients have difficulty in reporting their symptoms. Accurate surrogate measures are needed for appropriate assessment and treatment. The Respiratory Distress Observation Scale (RDOS) is proposed as a possible scale although more external validation is needed. We set out to validate the RDOS in the context of palliative care patients near the end of life. METHODS: We prospectively studied 122 palliative care patients in a tertiary hospital in Singapore...
November 1, 2018: Journal of Pain and Symptom Management
Daniel Gainza-Miranda, Eva Maria Sanz-Peces, Alberto Alonso-Babarro, María Varela-Cerdeira, Concepción Prados-Sánchez, Guadalupe Vega-Aleman, Ricardo Rodriguez-Barrientos, Elena Polentinos-Castro
BACKGROUND AND AIM: Consensus has been reached on the need to integrate palliative care in the follow-up examinations of chronic obstructive pulmonary disease (COPD) patients. We analyzed the survival from the initiation of follow-up by a palliative home care team (PHCT) and described the needs and end-of-life process. SETTING AND DESIGN: This study was a prospective observational cohort study of advanced COPD patients referred to a PHCT. Sociodemographic variables, survival from the start date of follow-up using the Kaplan-Meier model, health resource consumption, perceived quality of life, main symptomatology, opioid use, and advanced care planning (ACP) were analyzed...
November 2, 2018: Journal of Palliative Medicine
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Andrea Cortegiani, Alessandra Casuccio
AIM: The aim of this study was to investigate the relationship between delirium and symptom expression in patients with advanced cancer admitted to an acute supportive/palliative care unit (ASPCU). METHODS: A consecutive sample of patients with advanced cancer who were admitted to an ASPCU was prospectively assessed for a period of 10 months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after 7 days of palliative care (T7)...
October 24, 2018: Oncologist
Giovanna Sirianni, Giulia Perri, Jeannie Callum, Sandra Gardner, Anna Berall, Debbie Selby
BACKGROUND: There remains limited data in the literature on the frequency, clinical utility and effectiveness of transfusions in palliative care, with no randomized controlled trials or clinical practice guidelines on this topic. There are no routinely accepted practices in place for the appropriate transfusion of blood products in this setting. AIM: The aim of this study was to retrospectively review all transfusions in the palliative care units of 2, tertiary care hospitals in Canada...
October 18, 2018: American Journal of Hospice & Palliative Care
Sebastiano Mercadante, Claudio Adile, Federica Aielli, Lanzetta Gaetano, Kyriaki Mistakidou, Marco Maltoni, Luiz Guilherme Soares, Stefano De Santis, Patrizia Ferrera, Marta Rosati, Romina Rossi, Alessandra Casuccio
AIM: The aim of this study was to assess the Personalized Dyspnea Intensity Goal, and the achievement of Personalized Goal Response and Patient Global impression, after comprehensive symptom management. The secondary outcome was to assess factors related to personalized goal response. PATIENTS AND METHODS: Advanced cancer patients admitted to palliative care units rated pain and symptoms intensity, and their Personalized Dyspnea Intensity Goal , by using the Edmonton Symptom Assessment Score (ESAS)...
October 15, 2018: Journal of Pain and Symptom Management
Helen Senderovich, Akash Yendamuri
INTRODUCTION: Dyspnea is prominently observed in palliative care (PC). Dyspnea can be multifactorial, primarily caused by obstructive or restrictive lung diseases or secondarily induced by various comorbidities. Numerous interventions exist, with route of administration and efficacy requiring further discussion. Despite opioids being the first line of treatment, their adverse effects lead to reluctance on the side of patients to take them, creating limitations in patient management planning...
October 16, 2018: Rambam Maimonides Medical Journal
Haider Javed Warraich, Joseph G Rogers, Shannon M Dunlay, Ellen Hummel, Robert J Mentz
Heart failure (HF) is an increasingly prevalent condition with a very high symptom burden. To address challenges faced by palliative care clinicians, we assembled a team of experts to provide high-yield tips for the management of these patients. Prognosis is unpredictable in HF and many patients and physicians overestimate survival. Ejection fraction, notably, is not predictive of prognosis. It is important to have thorough discussions about implantable cardioverter defibrillators in terminally ill HF patients...
November 2018: Journal of Palliative Medicine
K Ducharlet, V Sundarajan, J Philip, J Weil, N Barker N, R G Langham, J Burchell, H Gock
Symptom and quality of life (QOL) measures in patients with advanced chronic kidney disease (CKD) are recognised indicators of patient-centred care and represent important research, quality and clinical measures. This study examined relationships between symptom burden, QOL and functional status and associations of symptoms and mortality risk. A multisite longitudinal cohort analysis was undertaken in CKD stage 4/5 (no dialysis, ND) and dialysis patients. Patients completed symptom and QOL measures (Palliative Care Outcome Symptom Score (POS-S renal) [1], World Health Organisation QOL, WHOQOL-BREF) [2] and Karnofsky Performance scale [3]...
October 8, 2018: Nephrology
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