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Physical therapy and palliation

Katharina Linse, Elisa Aust, Markus Joos, Andreas Hermann
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease, leading to progressive paralysis, dysarthria, dysphagia, and respiratory disabilities. Therapy is mostly focused on palliative interventions. During the course of the disease, verbal as well as nonverbal communicative abilities become more and more impaired. In this light, communication has been argued to be "the essence of human life" and crucial for patients' quality of life. High-tech augmentative and alternative communication (HT-AAC) technologies such as eyetracking based computer devices and brain-computer-interfaces provide the possibility to maintain caregiver-independent communication and environmental control even in the advanced disease state of ALS...
2018: Frontiers in Neurology
Muhammad Hassan Majeed, Ali Ahsan Ali, Donna M Sudak
Background Long-term use of opioids to treat chronic pain incurs serious risks for the individual-including misuse, abuse, addiction, overdose and death-as well as creating economic, social, and cultural impacts on society as a whole. Chronic pain and substance use disorders are often co-morbid with other medical problems and at the present time, primary care clinicians serve most of this population. Primary care clinicians would benefit from having alternatives to opioids to employ in treating such patients...
August 9, 2018: International Journal of Psychiatry in Medicine
Gary Rodin
The human dimensions of medical care were highlighted by such pioneering figures as Cicely Saunders, Elizabeth Kubler-Ross and Jimmie Holland and their tireless advocacy helped to build an evidence base for psychosocial and palliative interventions. In that spirit, we studied physical and psychological distress in advanced cancer and modelled pathways to distress in this population. We considered acute stress disorder (ASD) as the prototype for psychological disturbances following the acute onset of life-threatening disorders, showing that it occurred in one-third of patients after the diagnosis of acute leukemia, To treat and prevent these symptoms, we developed Emotion and Symptom-Focused Engagement (EASE), an integrated psychotherapeutic and palliative intervention...
July 6, 2018: Psycho-oncology
Zheng Chen, Huiling Liu, Hong Wang, Changshun Wu, Hong Feng, Junqing Han
Objective: The tumor inhibition by magnetic fields (MFs) has been reported in many in vivo and in vitro studies, while clinical trials have been rare. This report aimed to evaluate the improvement of survival and general symptoms in advanced cancer patients treated with MFs. Subjects and Methods: In this study, we investigated 21 patients with advanced gastric cancer (AGC) treated with 420 r/min, 0.4-T low-frequency rotary MFs. The treatment area encompassed the primary tumor sites, metastatic sites, and metastatic lymph nodes...
2018: Journal of Cancer Research and Therapeutics
Giuseppe Roberto Giammalva, Domenico Gerardo Iacopino, Giorgio Azzarello, Claudia Gaggiotti, Francesca Graziano, Carlo Gulì, Maria Angela Pino, Rosario Maugeri
High-grade gliomas (HGGs) are the most frequently diagnosed primary brain tumors. Even though it has been demonstrated that combined surgical therapy, chemotherapy, and radiotherapy improve survival, HGGs still harbor a very poor prognosis and limited overall survival. Differently from other types of primary neoplasm, HGG manifests also as a neurological disease. According to this, palliative care of HGG patients represents a peculiar challenge for healthcare providers and caregivers since it has to be directed to both general and neurological cancer symptoms...
June 30, 2018: Brain Sciences
Jomjit Chantharasamee, Jitsupa Treetipsatit
A 51-year-old Thai woman presented with bilateral leg edema and painful left inguinal mass for 6 months. Physical examination revealed matted bilateral inguinal lymph nodes up to 9 cm in size. Otherwise, physical examinations including skin were unremarkable. The result of the lymph node incisional biopsy is consistent with that of metastatic melanoma. The extensive investigation demonstrated multiple intra-abdominal and inguinal lymph nodes without detectable primary tumor. Palliative radiation and conventional chemotherapy were prescribed...
2018: Case Reports in Oncological Medicine
M K Doherty, Y Leung, J Su, H Naik, D Patel, L Eng, Q Q Kong, F Mohsin, M C Brown, O Espin-Garcia, A Vennettilli, D J Renouf, O O Faluyi, J J Knox, H MacKay, R Wong, D Howell, N Mittmann, G E Darling, D Cella, W Xu, G Liu
Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG...
June 14, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Masato Shigeyama, Maho Taguchi, Hiromitsu Yamamoto
 Mohs' paste (MP), which is widely used in medical services as a specific hospital preparation, has been considered to have demerits, such as increased hardness after preparation and marked adhesiveness. However, factors associated with variations in its physical properties have not yet been clarified. Therefore, we conducted studies to clarify the physicochemical phenomena influencing such variations, and also examined prescription drug designs of MP preparations that are difficult to use clinically due to the above-mentioned demerits, with a view to improving their usability...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Shir Galin, Irit Heruti, Noa Barak, Marc Gotkine
The psychological phenotype in amyotrophic lateral sclerosis (ALS) is less negative than in other neurodegenerative diseases, manifested by a lower prevalence of psychopathology, such as anxiety and major depression, and a higher perceived quality of life by patients, irrespective of physical impairment. We hypothesized that positive psychological factors such as hope, optimism, and self-efficacy in people with ALS (PALS) were key determinants of satisfaction with life (SWL), despite physical impairment, and were protective against psychopathology...
May 31, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Chai Hong Rim, Won Sup Yoon
The use of external beam radiation therapy (EBRT) in the treatment of hepatocellular carcinoma (HCC), which was rarely performed due to liver toxicity with a previous technique, has increased. Palliation of portal vein thrombosis, supplementation for insufficient transarterial chemoembolization, and provision of new curative opportunities using stereotactic body radiotherapy are the potential indications for use of EBRT. The mechanism of EBRT treatment, with its radiobiological and physical perspectives, differs from those of conventional medical treatment or surgery...
2018: OncoTargets and Therapy
Ana Ubeda Tikkanen, Meena Nathan, Lynn A Sleeper, Marisa Flavin, Ana Lewis, Donna Nimec, John E Mayer, Pedro Del Nido
BACKGROUND: Patients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in-hospital stay. However, information on the types of acute postcardiac surgery therapy needs in children is scarce. Our goal was to describe rehabilitation therapy following congenital heart surgery and pre/intraoperative factors associated with need for therapy...
May 12, 2018: Journal of the American Heart Association
Bronwyn Hilder, Pieter VanDam, Kathleen Doherty
The purpose of this scoping review is to examine the literature regarding the development, implementation, scope and extent of Advanced Practice Radiation Therapist (APRT) roles in Australia in peer reviewed journals, government reports, conference proceedings and reports. A search was undertaken of PubMed, Web of Science and CINAHL, the ASMIRT website and, and Google Scholar to identify relevant documents. Combinations of keywords with Boolean operators ((advanced practice) OR (advanced practitioner) OR (specialist)) AND ((radiation therapist) OR (radiation therapy)) were used...
June 2018: Journal of Medical Radiation Sciences
Katie Wiskar, Mustafa Toma, Barret Rush
Palliative care (PC) is now recommended by all major cardiovascular societies for advanced heart failure (HF). PC is a philosophy of care that uses a holistic approach to address physical, psychosocial, and spiritual needs in patients with a terminal disease process. In HF, PC has been shown to improve symptoms and quality of life, facilitate advanced care planning, decrease hospital readmissions, and decrease hospital-associated healthcare costs. Although PC is still underutilized in HF, uptake is increasing...
February 21, 2018: Trends in Cardiovascular Medicine
Daniel Breadner, Mark David Vincent, Derek Jonker, Christine Cripps, Paul Klimo, James Biagi, Wendy Lam, Anne O'Connell, Frances Whiston, Larry Stitt, Stephen Welch
OBJECTIVES: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial. METHODS: A single arm multi-centered phase II trial of dose reduced capecitabine (1500 or 2000 mg/m2  days one-fourteen q21 days) in older or frail patients...
May 1, 2018: Journal of Geriatric Oncology
Asbjørn M Drewes, Claudia M Campbell, Güralp O Ceyhan, Myriam Delhaye, Pramod K Garg, Harry van Goor, Berta Laquente, Bart Morlion, Søren S Olesen, Vikesh K Singh, Per Sjøgren, Eva Szigethy, John A Windsor, Marina G Salvetti, Rupjyoti Talukdar
Abdominal pain is an important symptom in most patients with pancreatic ductal adenocarcinoma (PDAC). Adequate control of pain is often unsatisfactory due to limited treatment options and significant variation in local practice, emphasizing the need for a multidisciplinary approach. This review contends that improvement in the management of PDAC pain will result from a synthesis of best practice and evidence around the world in a multidisciplinary way. To improve clinical utility and evaluation, the evidence was rated according to the GRADE guidelines by a group of international experts...
June 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Lidija Gović-Golčić, Aleksandar Čubranić
PURPOSE: Survival analysis is an important issue in palliative care. However, there is a lack of quality clinical biomarkers for assessing survival, especially in bedridden patients. Recent research supports the benefit of physiotherapy in palliative care, as majority of hospice patients are able to perform physical therapy. We propose the hypothesis that the difference in activity during physical exercise can be used as a biomarker of survival in hospice care. METHODS: We examined 536 consecutive patients who performed physical exercises in our hospice from March 2013 to July 2017...
January 1, 2018: American Journal of Hospice & Palliative Care
Massimo Romanò
Heart failure (HF) is one of the leading causes of hospitalization in high-income countries and has a profound negative impact on quality of life. In the United States there are more than 900,000 new cases per year and over one million hospital admissions with a primary diagnosis of HF. A prevalence of 6,500,000 cases (2.2% of the population of aged >20 years) was estimated for the US in 2014, in which there were 300,000 related deaths. Although survival has increased, thanks to the pharmacological and non pharmacological therapy, roughly 50% of HF patients die within 5 years of being diagnosed...
April 2018: Recenti Progressi in Medicina
Weijia Wang, Cynthia A James, Hugh Calkins
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is a rare inherited heart muscle disease characterized by ventricular tachyarrhythmia, predominant right ventricular dysfunction, and sudden cardiac death. Its pathophysiology involves close interaction between genetic mutations and exposure to physical activity. Mutations in genes encoding desmosomal protein are the most common genetic basis. Genetic testing plays important roles in diagnosis and screening of family members. Syncope, palpitation, and lightheadedness are the most common symptoms...
April 23, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Amar D Bansal, Amanda Leonberg-Yoo, Jane O Schell, Jennifer S Scherer, Christopher A Jones
Many patients with chronic kidney disease (CKD) and end-stage renal disease have unmet palliative care (PC) needs. Physical and emotional symptoms are common. Some, like uremia and fluid overload, improve with dialysis, but the increasing age of patients initiating renal replacement therapy leaves many untreatable comorbidities like dementia and frailty to negatively impact quality of life. Written by nephrologists and PC clinicians, this article will help PC providers to have a richer understanding of kidney disease-related symptom burden, disease trajectory, prognosis, and barriers to hospice enrollment for patients with CKD and end-stage renal disease...
April 2018: Journal of Palliative Medicine
N Bradley, M Lloyd-Williams, C Dowrick
Individuals managing the challenges of life-limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion...
May 2018: European Journal of Cancer Care
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