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Palliative pain

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https://www.readbyqxmd.com/read/28429629/developing-indicators-of-appropriate-and-inappropriate-end-of-life-care-in-people-with-alzheimer-s-disease-cancer-or-chronic-obstructive-pulmonary-disease-for-population-level-administrative-databases-a-rand-ucla-appropriateness-study
#1
Robrecht De Schreye, Dirk Houttekier, Luc Deliens, Joachim Cohen
BACKGROUND: A substantial amount of aggressive life-prolonging treatments in the final stages of life has been reported for people with progressive life-shortening conditions. Monitoring appropriate and inappropriate end-of-life care is an important public health challenge and requires validated quality indicators. AIM: To develop indicators of appropriate and inappropriate end-of-life care for people with cancer, chronic obstructive pulmonary disease or Alzheimer's disease, measurable with population-level administrative data...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28428505/-neurolysis-and-spinal-analgesia-in-cancer-pain-management
#2
Seiji Hattori, Junko Tachibana
Cancer pain appears as a complex pain and often progressive.WhenWHO pain management strategy and/or palliative care failed to relieve their pain, patients are given high dose opioids or anonymous adjuvant drugs and have no chance to meet specialized pain treatment. This section briefly covers the outline of neurolysis and spinal analgesia for these cancer patients with severe pain. Purpose of nerve block and neurolysis are to block the incoming signal of pain in order to reduce pain, reduce analgesic dose, recover ADL, and finally to be discharged from the hospital...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28427740/a-study-of-the-incidence-and-management-of-admissions-for-cancer-related-symptoms-in-a-district-general-hospital-the-potential-role-of-an-acute-oncology-service
#3
C M Bruce, J Smith, A Price
AIMS: The non-specialist management of cancer patients is becoming increasingly complex. Acute oncology services (AOS), aiming to provide rapid access to specialist advice, have been shown to improve patient experience and reduce length of inpatient stay. The present study aimed to inform service provision in a district general hospital (DGH) by investigating cancer patients, not on active anti-cancer treatment, where the disease itself precipitated admission. This is a vulnerable group who are potentially disenfranchised of focused oncological input due to having less robust care pathways established to date...
April 17, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28426271/factors-associated-with-the-efficacy-of-trigger-point-injection-in-advanced-cancer-patients
#4
Hideaki Hasuo, Kenji Kanbara, Tetsuya Abe, Hiroko Sakuma, Mikihiko Fukunaga
BACKGROUND: Few studies have reported the efficacy of trigger point injection (TPI) to myofascial trigger points (MTrPs) in advanced cancer patients. Factors that are associated with TPI efficacy have not yet been elucidated. OBJECTIVE: The study was aimed at evaluating factors that are associated with TPI efficacy to MTrPs in advanced cancer patients. DESIGN: Factors that are associated with TPI efficacy were retrospectively identified based on a comparison between clinically relevant responders and nonresponders by using multivariate regression analysis...
April 20, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28424195/thyroid-skeletal-metastasis-pain-management-with-verteblation
#5
Gianluigi Orgera, Miltiadis Krokidis, Alberto Rebonato, Marcello Andrea Tipaldi, Luca Mascagni, Michele Rossi
The combination of percutaneous vertebroplasty with radiofrequency ablation (verteblation) has not shown to be an effective measure of pain management in patients with metastatic lesions of the spine. The use of this novel technique has not been previously described in metastatic disease from thyroid cancer. We would like to report our experience after treating a patient affected by a thyroid carcinoma and an osteolytic spine metastasis. The patient suffered from life-limiting pain and was successfully treated with a combination of vertebroplasty and radiofrequency ablation...
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28424041/endovascular-treatment-of-massive-axillary-artery-aneurysm-for-palliation
#6
David A Epstein, M Taha Ibrahim, Randall W Franz
Atherosclerotic axillary artery aneurysms are rare. We report a case of a ninety six year old female who presented with a pulsatile left breast mass causing her intractable pain. She was diagnosed with a massive axillary artery aneurysm which was treated with and endovascular aneurysm repair for palliation of her symptoms.
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28423478/a-qualitative-study-of-community-nurses-decision-making-around-the-anticipatory-prescribing-of-end-of-life-medications
#7
Ben Bowers, Sarah Redsell
AIMS: To explore community nurses' decision-making processes around the prescribing of anticipatory medications for people who are dying. BACKGROUND: Community nurses frequently initiate the prescribing of anticipatory medications to help control symptoms in those who are dying. However, little is known about their decision-making processes in relation to when they instigate anticipatory prescribing and their discussions with families and General Practitioners. DESIGN: A qualitative interpretive descriptive enquiry...
April 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28421240/a-randomised-phase-ii-study-of-repeated-rhenium-188-hedp-combined-with-docetaxel-and-prednisone-versus-docetaxel-and-prednisone-alone-in-castration-resistant-prostate-cancer-crpc-metastatic-to-bone-the-taxium-ii-trial
#8
Joyce M van Dodewaard-de Jong, John M H de Klerk, Haiko J Bloemendal, Daniela E Oprea-Lager, Otto S Hoekstra, H Pieter van den Berg, Maartje Los, Aart Beeker, Marianne A Jonker, Joe M O'Sullivan, Henk M W Verheul, Alfons J M van den Eertwegh
BACKGROUND: Rhenium-188-HEDP is a beta-emitting radiopharmaceutical used for palliation of metastatic bone pain. We investigated whether the addition of rhenium-188-HEDP to docetaxel/prednisone improved efficacy of chemotherapy in patients with CRPC. METHODS: Patients with progressive CRPC and osteoblastic bone metastases were randomised for first-line docetaxel 75 mg/m(2) 3-weekly plus prednisone with or without 2 injections of rhenium-188-HEDP after the third (40 MBq/kg) and after the sixth (20 MBq/kg) cycle of docetaxel...
April 18, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28415802/application-of-embolization-microspheres-in-interventional-therapy-of-malignant-non-hypervascular-tumor-of-liver
#9
Huanzhang Niu, Tingwei Du, Quanping Xiao, Xin Hu, Dongmin Li, Chao Wang, Wanqin Gao, Taohong Xing, Xiangmei Xu
OBJECTIVE: To investigate the efficacy and safety of transarterial embolization (TAE) using embolization microspheres in the treatment of non-hypervascular malignant liver tumors. METHODS: Patients with malignant non-hypervascular liver tumors, who were treated with TAE using embolization microspheres, were selected and analyzed retrospectively. The technical success rate, tumor response, and complications were assessed. RESULTS: Six patients were included in the study: 1 patient each with hepatocellular-cholangiocarcinoma, intrahepatic cholangiocarcinoma, hepatic metastasis after resection of common bile duct carcinoma, liver metastasis from colon cancer, liver metastasis from esophageal cancer, and liver metastasis from pancreatic cancer...
March 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413788/a-tertiary-care-experience-with-paclitaxel-and-cetuximab-as-palliative-chemotherapy-in-platinum-sensitive-and-nonsensitive-in-head-and-neck-cancers
#10
Vanita Noronha, Vijay M Patil, Amit Joshi, Atanu Bhattacharjee, Davinder Paul, Sachin Dhumal, Shashikant Juvekar, Supreeta Arya, Kumar Prabhash
BACKGROUND: The combination of paclitaxel and cetuximab (PaCe) has led to an encouraging response rate in Phase 2 setting with limited toxicity. The aim of our study was to assess the efficacy of this regimen in our setting in platinum sensitive and nonsensitive patients. METHODS: This was a retrospective analysis of head and neck cancer patients treated with weekly PaCe as palliative chemotherapy between May 2010 and August 2014. The standard schedule of cetuximab along with 80 mg/m(2) of weekly paclitaxel was administered till either disease progression or withdrawal of patient's consent...
January 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28413658/subcutaneous-metastasis-arising-from-gastric-cancer-a-case-report
#11
Tsutomu Namikawa, Eri Munekage, Masaya Munekage, Hiromichi Maeda, Tomoaki Yatabe, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki
A 59-year-old man was referred to the Kochi Medical School Hospital due to left shoulder pain. Physical examination revealed a nodular, painful mass lesion in the subcutaneous tissue of the right chest wall, with a diameter of ~2 cm. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower gastric body near the lesser curvature, and biopsy specimens of the gastric and humeral lesions revealed poorly differentiated adenocarcinoma. Abdominal computed tomography revealed multiple low-density lesions in the liver and a well-defined, 2...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28409420/single-fraction-spine-stereotactic-ablative-body-radiotherapy-with-volumetric-modulated-arc-therapy
#12
Matthew M Gestaut, Nitika Thawani, Sangroh Kim, Veera R Gutti, Sameer Jhavar, Niloyjyoti Deb, Andrew Morrow, Russell A Ward, Jason H Huang, Mehul Patel
This study investigated a single institution's experience with volumetric modulated arc therapy (VMAT) directed stereotactic ablative body radiotherapy (SABR) for vertebral metastases. From 2010 to 2014, 95 lesions of spinal metastases in 73 patients were treated with SABR using VMAT. Clinical local control, pain level, and use of steroid medication were employed to evaluate treatment responses. The majority (79%) of patients were treated with a radiation dose of 20 Gy in a single fraction. However, when normal tissue constraints could not be achieved, the dose was reduced to 18 Gy (11%) or 16 Gy (8%) in 1 fraction...
April 13, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28405120/fractionated-palliative-pelvic-radiotherapy-as-an-effective-modality-in-the-management-of-recurrent-refractory-epithelial-ovarian-cancers-an-institutional-experience
#13
Anshuma Bansal, Bhavana Rai, Shikhar Kumar, Vanita Suri, Sushmita Ghoshal
BACKGROUND: The advent of effective chemotherapeutic agents for ovarian carcinoma has made radical abdomino-pelvic radiation redundant. Nevertheless, palliative pelvic radiotherapy still has a role in palliating local symptoms. However, its effect on progression-free survival (PFS) may be debated. AIMS: To study the outcome of fractionated palliative pelvic radiotherapy in relapsed ovarian cancers in terms of symptom control and PFS. METHODS: Twenty-three patients of ovarian cancers, heavily pretreated with chemotherapy and with recurrent or residual pelvic masses, were planned for palliative pelvic radiotherapy to the dose of 46-50 Gy in 23-25 fractions in 4...
April 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28401138/prevalence-of-symptoms-at-the-end-of-life-in-an-acute-care-hospital-a-retrospective-cohort-study
#14
Daniel Kobewka, Paul Ronksley, Dan McIsaac, Sunita Mulpuru, Alan Forster
BACKGROUND: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. METHODS: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28386785/assessing-the-prognostic-features-of-a-pain-classification-system-in-advanced-cancer-patients
#15
Joseph Arthur, Kimberson Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane Liu, Eduardo Bruera
PURPOSE: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between ECS-CP features and pain treatment outcomes among outpatients managed by a palliative care specialist-led interdisciplinary team. METHODS: Initial and follow-up clinical information of 386 eligible supportive care outpatients were retrospectively reviewed and analyzed...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28386399/development-of-research-priorities-in-paediatric-pain-and-palliative-care
#16
Christina Liossi, Anna-Karenia Anderson, Richard F Howard
Priority setting for healthcare research is as important as conducting the research itself because rigorous and systematic processes of priority setting can make an important contribution to the quality of research. This project aimed to prioritise clinical therapeutic uncertainties in paediatric pain and palliative care in order to encourage and inform the future research agenda and raise the profile of paediatric pain and palliative care in the United Kingdom. Clinical therapeutic uncertainties were identified and transformed into patient, intervention, comparison and outcome (PICO) format and prioritised using a modified Nominal Group Technique...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28385942/epidermal-growth-factor-receptor-mutations-should-be-considered-as-a-prognostic-factor-for-survival-of-patients-with-pathological-fractures-or-painful-bone-metastases-from-non-small-cell-lung-cancer
#17
J J Willeumier, N M A van der Hoeven, L Bollen, L N A Willems, M Fiocco, Y M van der Linden, P D S Dijkstra
AIMS: This study aims to assess first, whether mutations in the epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (kRAS) genes are associated with overall survival (OS) in patients who present with symptomatic bone metastases from non-small cell lung cancer (NSCLC) and secondly, whether mutation status should be incorporated into prognostic models that are used when deciding on the appropriate palliative treatment for symptomatic bone metastases. PATIENTS AND METHODS: We studied 139 patients with NSCLC treated between 2007 and 2014 for symptomatic bone metastases and whose mutation status was known...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384070/the-palliative-care-quality-network-improving-the-quality-of-caring
#18
Steven Z Pantilat, Angela K Marks, Kara E Bischoff, Ashley R Bragg, David L O'Riordan
OBJECTIVE: Describe the establishment of the palliative care quality network (PCQN) with guidance on how teams can develop similar collaborations. BACKGROUND: In the current healthcare environment, palliative care (PC) teams must be able to demonstrate value and provide efficient care while supporting the clinicians who provide that care. DESCRIPTION: The PCQN is a national quality improvement (QI) collaborative comprised of specialty PC teams from a diverse range of hospitals across the United States Results: PCQN members identified five core activities to support PC teams...
April 6, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#19
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
April 4, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28375640/coriolus-versicolor-yunzhi-use-as-therapy-in-advanced-hepatocellular-carcinoma-patients-with-poor-liver-function-or-who-are-unfit-for-standard-therapy
#20
Wen Yee Chay, Chee Kian Tham, Han Chong Toh, Hwee Yong Lim, Chee Kiat Tan, Cindy Lim, Who-Whong Wang, Su-Pin Choo
BACKGROUND: The majority of patients with hepatocellular carcinoma (HCC) are inoperable and results with conventional chemotherapy are dismal. Many end up with no treatment options and resort to alternative medicine. The authors report the use of Coriolus versicolor (CV) in advanced HCC patients with poor liver function or who were unfit to receive standard therapy. METHODS: Fifteen eligible cases were randomized 2:1 to either CV or placebo. The primary endpoint was the median time to progression (TTP) between both arms...
April 4, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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