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Palliative pain

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https://www.readbyqxmd.com/read/29350645/developments-in-the-management-of-bone-metastases-with-interventional-radiology
#1
Francesco Arrigoni, Federico Bruno, Luigi Zugaro, Raffaele Natella, Salvatore Cappabianca, Umberto Russo, Vito Roberto Papapietro, Alessandra Splendiani, Ernesto Di Cesare, Carlo Masciocchi, Antonio Barile
Interventional radiology has known an exponential growth in the last years. Technological advances of the last decades, have made it possible to use new treatments on a larger scale, with safe and effective results. They could be considered as palliative treatments for painful lesions but also curative procedures, as single treatment or specially in combination with other techniques (surgery, radiation and oncology therapies, etc.).The main diffuse techniques are those of thermal ablation that destroy the target lesion through the heat; however there are also endovascular therapies that destroy the target tissue thanks to devascularization...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29347855/low-power-bipolar-radiofrequency-ablation-and-vertebral-augmentation-for-the-palliative-treatment-of-spinal-malignancies
#2
Roberto Luigi Cazzato, Julien Garnon, Jean Caudrelier, Pramod Prabhakar Rao, Guillaume Koch, Afshin Gangi
AIM: To investigate the analgesic properties and the safety of low power bipolar radiofrequency ablation (RFA) performed with internally cooled electrodes and vertebral augmentation for the treatment of painful spinal malignancies. MATERIALS AND METHODS: Consent was waived for retrospective study participation. Review of electronic records identified 11 consecutive patients (6 females; 5 males; mean age 61.3 ± 11.6 years) with one-index painful spinal tumour, who were treated between June 2016 and October 2017 with bipolar RFA and vertebral augmentation...
January 18, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29346304/-total-pain-in-children-with-severe-neurological-impairment
#3
REVIEW
Timothy A Warlow, Richard D W Hain
Many children with palliative care needs experience difficulty in managing pain. Perhaps none more so than those with severe neurological impairment. For many years; behaviours in these children were misunderstood. As a result; pain was poorly recognised and inadequately managed. Significant advances have been made in the assessment and management of pain in this challenging group of patients. We summarise these advances; drawing on our own experience working with infants; children and young adults with palliative care needs within a UK tertiary paediatric palliative care service...
January 18, 2018: Children
https://www.readbyqxmd.com/read/29344820/metastases-from-distant-primary-tumours-on-the-head-and-neck-clinical-manifestation-and-diagnostics-of-91-cases
#4
Sven Holger Baum, Christopher Mohr
PURPOSE: The aim of this study was to evaluate which primary tumours metastasize on the head and neck region, identify the kind of clinical manifestation, the types of diagnostics that should be performed, and prove that the therapy appears possible and useful. PATIENTS: As many as 91 patients with a distant metastasis on the head and neck were enrolled in this retrospective clinical study from January 2004 to September 2016. All the patients were evaluated for clinical symptoms, primary tumour, localization, diagnostics, and surgical procedure...
January 17, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29344766/patient-reported-symptoms-before-palliative-radiotherapy-predict-survival-differences
#5
Carsten Nieder, Thomas A Kämpe, Adam Pawinski, Astrid Dalhaug
BACKGROUND: Widely used prognostic scores, e. g., for brain or bone metastases, are based on disease- and patient-related factors such as extent of metastases, age and performance status, which were available in the databases used to develop the scores. Few groups were able to include patient-reported symptoms. In our department, all patients were assessed with the Edmonton Symptom Assessment System (ESAS, a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of 0-10) at the time of treatment planning since 2012...
January 17, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29344716/safety-and-effectiveness-of-palliative-tunneled-peritoneal-drainage-catheters-in-the-management-of-refractory-malignant-and-non-malignant-ascites
#6
Jennifer A Knight, Scott M Thompson, Chad J Fleming, Emily C Bendel, Melissa J Neisen, Newton B Neidert, Andrew H Stockland, Haraldur Bjarnason, David A Woodrum
PURPOSE: To determine the safety and effectiveness of tunneled peritoneal catheters in the management of refractory malignant and non-malignant ascites. MATERIALS AND METHODS: An IRB-approved retrospective review was undertaken of patients who underwent ultrasound and fluoroscopy-guided tunneled peritoneal catheter placement for management of refractory malignant or non-malignant ascites between January 1, 2009, and March 14, 2014. RESULTS: A total of 137 patients (76 M/61 F, mean age 62...
January 17, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29333821/opioid-treatment-for-mixed-pain-in-pediatric-patients-assisted-by-the-palliative-care-team-five-years-of-experience
#7
María L Yazde Puleio, Karina V Gómez, Ana Majdalani, Vilma Pigliapoco, Gisella Santos Chocler
Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Depending on its pathophysiological mechanism, it may be classified into nociceptive, neuropathic, and mixed pain. If pain is moderate to severe, a strong opioid should be administered and, when this is the case, morphine is the drug of choice. If morphine is ineffective or causes intolerable adverse effects, opioid rotation is recommended. Our objective was to describe the drug management for mixed pain used in patients assisted by the Palliative Care team of Hospital General de Niños Pedro de Elizalde between August 2011 and September 2015...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29333025/primary-leiomyosarcoma-of-breast-presenting-with-metastasis-an-atypical-presentation-with-dismal-prognosis
#8
Garima Singh, Deepti Sharma, Surbhi Goyal
Leiomyosarcoma is an extremely uncommon subtype of breast sarcoma, with <50 cases reported in the English literature till date. Patients usually present at an early stage and follow an indolent course. We reported an unusual case of leiomyosarcoma of breast in a post -menopausal female,presented with right side breast lump and pain right side hip. Histomorphological evaluation and immunohistochemistry confirmed the diagnosis. The patient received palliative radiotherapy 20 Gy in 5 fractions to right iliac bone and was started on chemotherapy comprising of docetaxel and epirubicin...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29331343/irradiation-stents-vs-conventional-metal-stents-for-unresectable-malignant-biliary-obstruction-a-multicentre-trial
#9
Hai-Dong Zhu, Jin-He Guo, Ming Huang, Jian-Song Ji, Hao Xu, Jian Lu, Hai-Liang Li, Wen-Hui Wang, Yu-Liang Li, Cai-Fang Ni, Hai-Bin Shi, En-Hua Xiao, Wei-Fu Lv, Jun-Hui Sun, Ke Xu, Guo-Hong Han, Lin-An Du, Wei-Xin Ren, Mao-Quan Li, Ai-Wu Mao, Hua Xiang, Kai-Xian Zhang, Jie Min, Guang-Yu Zhu, Chang Su, Li Chen, Gao-Jun Teng
BACKGROUND & AIMS: Placement of an irradiation stent has been demonstrated to offer longer patency and survival when compared to an uncovered SEMS in patients with unresectable malignant biliary obstruction (MBO). We aim to further assess the efficacy of an irradiation stent compared to an uncovered SEMS in those patients. METHODS: We performed a randomized, open-label trial of participants with unresectable MBO at 20 centers in China. A total of 328 participants were parallelly allocated into the irradiation stent group (ISG) or the uncovered SEMS group (USG)...
January 10, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29325948/spinal-metastasis-resulting-from-atypical-thymic-carcinoid-a-case-report
#10
Xinjie Wu, Yingna Qi, Feng Yang, Mingsheng Tan, Jie Lin
BACKGROUND: Thymic carcinoid with spinal metastasis is an extremely rare entity. Clinically, the tumor presents either by its endocrine manifestations or by mechanical compression of surrounding structures. However, no previous studies reported a case with neck pain, and neurological deficit as initial presentation of an atypical thymic carcinoid. METHOD: A 56-year-old non-smoking man presented with 12-month history of intermittent neck pain and 1-month history of progressive numbness and weakness of the right upper limb...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325524/posterior-decompression-and-occipitocervical-fixation-followed-by-intraoperative-vertebroplasty-for-metastatic-involvement-of-the-axis
#11
Xinjie Wu, Mingsheng Tan, Yingna Qi, Ping Yi, Feng Yang, Xiangsheng Tang, Qingying Hao
BACKGROUND: Metastases to the upper cervical spine were rarely reported in the literature. However, metastases to this area may cause spinal instability and cord compression, which in turn can result in respiratory failure and neurological dysfunction. The present study investigated the efficacy and safety of posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for this disease. METHODS: This was a retrospective study that included 10 patients with metastatic involvement of the axis from March 2002 to May 2014...
January 11, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29325441/five-year-experience-of-an-inpatient-palliative-care-unit-at-an-academic-referral-center
#12
Myrick C Shinall, Sara F Martin, Jill Nelson, Richard S Miller, Matthew W Semler, Eli E Zimmerman, Christy C Noblit, E Wesley Ely, Mohana Karlekar
BACKGROUND: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. METHODS: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. RESULTS: Over these 5 years, there were 3321 admissions to the PCU...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29324681/ppoma-review-epidemiology-aetiopathogenesis-prognosis-and-treatment
#13
REVIEW
Thais Ligiero Braga, Ralph Santos-Oliveira
Generally, pancreatic polypeptide-secreting tumor of the distal pancreas (PPoma) is classified as a rare tumor, and may occur sporadically or be associated in families or with multiple endocrine neoplasia type 1 (NEM 1). It grows slowly, reaching large dimensions at the time of diagnosis and the symptomatology is fundamentally due to the mass effect, causing either non-specific abdominal pain or symptoms suggestive of obstruction of the pancreatic or biliary duct. Therefore, when detected, they are usually malignant, with metastases mainly in the liver...
January 11, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29323766/acupuncture-in-hospice-settings-a-qualitative-exploration-of-patients-experiences
#14
P McPhail, H Sandhu, J Dale, S Stewart-Brown
Whilst acupuncture has the potential to impact on many aspects of health and well-being, including end-of-life care, there is little research regarding patients' experiences of its effects within the context of palliative care in hospice settings. The aim of this study was to address this gap, by exploring patients' experiences of acupuncture within this setting. In-depth, semi-structured interviews were conducted with a sample of eighteen patients who had received acupuncture as part of hospice care. Transcription of data, with thematic analysis, identified two overarching themes: (1) participant perceptions of the effects of acupuncture including pain control, improved physical and emotional health, spiritual well-being and awareness of health as a holistic phenomenon; and (2) factors which participants believed enabled acupuncture to have these effects including the quality of the practitioner relationship, engagement of participants in the process of their treatment and prior expectations that acupuncture could work...
January 11, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29317145/evaluation-of-quality-of-life-outcomes-following-palliative-treatment-of-bone-metastases-with-magnetic-resonance-guided-high-intensity-focused-ultrasound-an-international-multicentre-study
#15
D Harding, S L Giles, M R D Brown, G R Ter Haar, M van den Bosch, L W Bartels, Y-S Kim, M Deppe, N M deSouza
AIMS: To determine quality of life (QoL) outcomes after palliation of pain from bone metastases using magnetic resonance-guided high intensity focused ultrasound (MR-guided HIFU), measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL and the QLQ-BM22 questionnaires. MATERIALS AND METHODS: Twenty patients undergoing MR-guided HIFU in an international multicentre trial self-completed the QLQ-C15-PAL and QLQ-BM22 questionnaires before and on days 7, 14, 30, 60 and 90 post-treatment...
January 6, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29317008/patients-with-advanced-cancer-and-depression-report-a-significantly-higher-symptom-burden-than-non-depressed-patients
#16
Kjersti Støen Grotmol, Hanne C Lie, Jon Håvard Loge, Nina Aass, Dagny Faksvåg Haugen, Patrick C Stone, Stein Kaasa, Marianne Jensen Hjermstad
OBJECTIVE: Clinical observations indicate that patients with advanced cancer and depression report higher symptom burden than nondepressed patients. This is rarely examined empirically. Study aim was to investigate the association between self-reported depression disorder (DD) and symptoms in patients with advanced cancer controlled for prognostic factors. METHOD: The sample included 935 patients, mean age 62, 52% males, from an international multicentre observational study (European Palliative Care Research Collaborative - Computerised Symptom Assessment and Classification of Pain, Depression and Physical Function)...
January 10, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29316883/active-ingredients-of-a-person-centred-intervention-for-people-on-hiv-treatment-analysis-of-mixed-methods-trial-data
#17
Keira Lowther, Richard Harding, Victoria Simms, Aabid Ahmed, Zipporah Ali, Nancy Gikaara, Lorraine Sherr, Hellen Kariuki, Irene J Higginson, Lucy Ellen Selman
BACKGROUND: A new model of care is required to meet the changing needs of people living with HIV (PLWH), particularly in low and middle-income countries, where prevalence is highest. We evaluated a palliative care intervention for PLWH in Mombasa, Kenya. Although we found no effect on pain (primary outcome), there was a positive effect on mental health (secondary outcome) in the intervention group. To inform replication and implementation, we have determined the active ingredients of the intervention and their mechanisms of action...
January 10, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29313129/characteristics-and-care-pathways-of-advanced-cancer-patients-in-a-palliative-supportive-care-unit-and-an-oncological-ward
#18
Sebastiano Mercadante, Paolo Marchetti, Claudio Adile, Amanda Caruselli, Patrizia Ferrera, Andrea Costanzi, Alessandra Casuccio
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered...
January 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29305321/factors-associated-with-symptom-relief-in-end-of-life-care-in-residential-care-homes-a-national-register-based-study
#19
Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström
BACKGROUND: Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. AIM: To explore the presence of symptoms and symptom relief, and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. METHOD: The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (n=22 855)...
January 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29301481/public-awareness-of-palliative-care-in-sweden
#20
Caroline Westerlund, Carol Tishelman, Inger Benkel, Carl Johan Fürst, Ulla Molander, Birgit H Rasmussen, Sylvia Sauter, Olav Lindqvist
OBJECTIVE: The aim of this study was to investigate the awareness of palliative care (PC) in a general Swedish population. DESIGN: We developed an e-survey based on a similar study conducted in Northern Ireland, consisting of 10 questions. Closed questions were primarily analyzed using descriptive statistics. Open questions were subject to inductive qualitative analysis. SUBJECTS: The study utilized a population sample of 7684 persons aged 18-66, of which 2020 responded, stratified by gender, age and region...
January 1, 2018: Scandinavian Journal of Public Health
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