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https://www.readbyqxmd.com/read/27920861/colon-cancer-metastasis-to-the-sternum-palliative-treatment-with-radiofrequency-ablation-and-cement-injection
#1
Bryan E Wessel, Douglas Coldwell
Colon cancer metastasis to bone is extremely rare and has devastating consequences on patients' quality of life. Furthermore, radiofrequency ablation in conjunction with cementoplasty to nonweight bearing, flat bones has not been widely reported as palliative treatment for pain as a result of bone metastasis. Here, we present a case of a 47-year-old man who developed a sternal metastasis from an invasive adenocarcinoma of the colon originally diagnosed several years prior. The pain from the metastasis was originally treated with external beam radiation therapy, but after 6 weeks of continuous pain, it was retreated using radiofrequency ablation in conjunction with cementoplasty...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920486/choroidal-and-skin-metastases-from-colorectal-cancer
#2
Joo Young Ha, Edward Hynseung Oh, Moon Ki Jung, Song Ee Park, Ji Tak Kim, In Gyu Hwang
Choroidal and skin metastasis of colon cancer is rare. In women, the frequency of cutaneous metastasis from colon cancer as the primary lesion in is 9% and skin metastasis occurs in 0.81% of all colorectal cancers. We report a patient with colonic adenocarcinoma who presented with visual disorder in her right eye and scalp pain as her initial symptoms. Contrast-enhance orbital magnetic resonance imaging with fat suppression revealed an infrabulbar mass, and skin biopsy of the posterior parietal scalp confirmed adenocarcinoma...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#3
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27903774/-they-shouldn-t-be-coming-to-the-ed-should-they-a-descriptive-service-evaluation-of-why-patients-with-palliative-care-needs-present-to-the-emergency-department
#4
Emilie Green, Sarah Ward, Will Brierley, Ben Riley, Henna Sattar, Tim Harris
BACKGROUND: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. METHODS: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period...
November 30, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27901408/four-steps-to-eliminate-or-reduce-pain-in-children-caused-by-needles-part-1
#5
Stefan J Friedrichsdorf
Dr Stefan Friedrichsdorf* speaks to Jade Parker, Commissioning Editor: Stefan J Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota, Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The interdisciplinary pain team is devoted to prevent and treat acute, procedural, neuropathic, psycho-social-spiritual, visceral, and chronic/complex pain for all inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota...
November 30, 2016: Pain Management
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#6
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#7
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27898147/existentiell-kris-i-livets-slutskede-f%C3%A3-rst%C3%A3-rker-de-fysiska-symtomen-minskad-%C3%A3-ngest-och-k%C3%A3-nsla-av-gemenskap-kan-minska-upplevelsen-av-sm%C3%A3-rta
#8
Peter Strang
Existential anxiety might reinforce bodily symptoms All crises have existential elements, but the crisis will transform to a predominantly existential crisis, when the dying person is no longer shielded from stressful thoughts about death, meaninglessness, existential loneliness and unsolved guilt issues. The suffering is not merely on an existential level, as the connection between body and mind is strong and existential anxiety might reinforce bodily symptoms, e.g. pain. In this article, the influence of death anxiety and loneliness is discussed in relation to pain treatment in palliative care...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27898139/farmakologisk-sm%C3%A3-rtlindring-har-central-roll-i-palliativ-v%C3%A3-rd-sm%C3%A3-rtfrihet-i-vila-och-acceptabel-natts%C3%A3-mn-%C3%A3-r-m%C3%A3-let-f%C3%A3-r-behandlingen-%C3%A2-som-b%C3%A3-r-individualiseras
#9
Staffan Lundström
Mechanism-based pain treatment in palliative care Pain is common among patients in palliative care and one of the most feared symptoms. Knowledge about effective pain management is therefore essential for clinicians. Successful pain management is mainly based on the medical history and clinical examination, resulting in an understanding of the present pain mechanism(s). The pain mechanism then forms the basis for the pharmacological treatment strategy which should be individualized and take into account factors such as kidney function, expected side effects, route of administration and concomitant medication...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27896390/-assisted-suicide-in-the-movies-what-is-not-shown
#10
Kurt W Schmidt
Whereas changes to the existing legal situation regarding assisted suicide have been a topic of controversial debate in Germany for the last few years, this issue has long been of interest for international film-makers. Since the mid-1980s, the theme of assisted suicide has repeatedly been taken up by cinema, predominantly as central to a relationship drama. A sick person asks somebody close to them for help. Often this somebody is a physician or a nurse, ultimately an obvious way of solving the practical problem of how the assistant is to gain access to a lethal substance...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27892676/palliative-care-for-patients-with-gynecologic-cancer-in-japan-a-japan-society-of-gynecologic-palliative-medicine-jsgpm-survey
#11
Masayuki Futagami, Yoshihito Yokoyama, Tetsumi Sato, Kazuyoshi Hirota, Muneaki Shimada, Etsuko Miyagi, Nao Suzuki, Masaki Fujimura
Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29...
January 10, 2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27891000/an-unusual-metastasis-of-lung-adenocarcinoma-biceps-brachii-muscle
#12
Muzaffer Sariaydin, Ersin Günay, Sevinc Sarinc Ulasli, Sibel Günay, Betül Demirciler Yavaş, Çiğdem Tokyol, Mükremin Uysal, Mehmet Ünlü
Skeletal muscle metastasis of nonsmall cell lung carcinoma (NSCLC) is a rare occurrence, and the most effective treatment modality is currently unknown. In this case presentation, we report a patient with NSCLC who underwent palliative radiotherapy for biceps muscle metastasis of NSLCS. Our case was a 49-year-old woman who had lung adenocarcinoma with biceps muscle metastasis. She had been followed up for 2 years due to Stage IV lung adenocarcinoma from whom a biopsy was taken from a painful mass in right arm that was found to be compatible with metastasis of lung adenocarcinoma...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27884196/palliative-treatment-of-pelvic-bone-tumors-using-radioiodine-125-i-brachytherapy
#13
Chongren Wang, Zhengqi Chen, Wei Sun, Yisilamu Yasin, Chuanyin Zhang, Xiaojun Ma, Jian Chen, Jiakang Shen, Yingqi Hua, Zhengdong Cai
BACKGROUND: Complete resection of pelvic bone tumors, especially recurrent and metastatic ones, is often impossible to achieve using conventional surgery. This study aimed to assess the benefits and adverse effects of computed tomography (CT)-guided radioiodine ((125)I) brachytherapy for inoperable recurrent and metastatic bone tumors of the pelvis. METHODS: This was a retrospective study of 22 patients with confirmed pelvic bone tumors (10 females and 12 males; 15-84 years; 21 with primary pelvic tumor and one with pelvic metastasis)...
November 25, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27883873/doctors
#14
Gaya Sritharan, Amber C Mills, Michele R Levinson, Anthea L Gellie
Objectives The aims of the present study were to investigate doctors' attitudes regarding the discussion and writing of not for resuscitation (NFR) orders and to identify potential barriers to the completion of these orders.Methods A questionnaire-based convenience study was undertaken at a tertiary hospital. Likert scales and open-ended questions were directed to issues surrounding the discussion, timing, understanding and writing of NFR orders, including legal and personal considerations.Results Doctors thought the presence of an NFR order both should and does alter care delivered by nursing staff, particularly delivery of pain relief, nursing observations and contacting the medical emergency team...
November 25, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27882270/impact-of-race-ethnicity-on-pain-management-outcomes-in-a-community-based-teaching-hospital-following-inpatient-palliative-care-consultation
#15
Duc Chung, Austin Sue, Susan Hughes, James Simmons, Tegest Hailu, Christine Swift, Patrick Macmillan
OBJECTIVE: To examine race/ethnicity differences in pain management outcomes following inpatient palliative care consultation. METHODS: We conducted a retrospective study based on data from a community-based teaching hospital in Fresno, CA, USA, from April 2014 to July 2015. One hundred sixty-one patients with life-limiting diagnoses and palliative care pain-related consultations were included. The patients were categorized into four racial groups: Caucasians, African-Americans, Hispanics, and Asians/Others...
October 10, 2016: Curēus
https://www.readbyqxmd.com/read/27882232/metastatic-gastric-cancer-to-the-female-genital-tract
#16
Hiroshi Matsushita, Kazushi Watanabe, Akihiko Wakatsuki
Metastases to the female genital tract from gastric cancer are rare, but they significantly worsen the prognosis of such patients. The potential routes for metastasis to the female genital tract from gastric cancer include hematogenous spread, lymphatic spread and surface implantation. The rate of lymphatic metastasis to the ovary from gastric cancer has been reported to be higher compared with that from colorectal cancer. Uterine or Fallopian tube metastases are usually secondary to ovarian metastases, which are typically identified prior to the detection of gastric cancer in half of all synchronous cases, with complaints of abdominal distention, pain, palpable mass, or abnormal uterine bleeding...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#17
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27878605/-special-medical-problems-in-end-of-life-care-crisis-at-the-end-of-life-which-therapy-is-adequate-and-when-is-redefining-treatment-goals-appropriate
#18
Gesine Benze, Bernd Alt-Epping, Friedemann Nauck
Crisis at the end of life are exceptional challenges for patients, relatives and therapists. With respect to the individual treatment goals and the patients' autonomy, therapeutic action should be commenced in an adequate manner in order to preserve the patients' quality of life as much as possible. Advance care planning for specific critical scenarios may be helpful in order to treat patients according to their wishes and values even if they are not capable to express themselves. Furthermore, a crisis plan can define the scope of action for therapists in emergency situations...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27878604/-paediatric-palliative-care-ppc-a-particular-challenge-tasks-aims-and-specifics
#19
Boris Zernikow, Barbara Gertz, Carola Hasan
In Germany, there are about 50,000 children, adolescents and young adults with life threatening or life limiting conditions, who will likely die due to their illness before reaching the age of 40. In recent years prevalence has increased significantly.The aim of paediatric palliative care (PPC) is to optimize quality of life for the child, adolescent or young adult and its whole family. Whenever possible the patient should be treated at home.The very complex and rare diseases as well as the patients' wide range of age and developmental stage are particularly challenging within PPC...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27878602/-he-is-not-that-important-anymore-general-practitioners-in-a%C3%A2-specialized-palliative-home-care-setting-from-a%C3%A2-patient-s-point-of-view
#20
Sven Schwabe, Gülay Ates, Benjamin Ewert, Jeroen Hasselaar, Michaela Hesse, Lisa Linge-Dahl, Birgit Jaspers, Lukas Radbruch
BACKGROUND: The outpatient medical care of palliative patients (PPs) has always fallen within the duties of general practitioners. Since the specialized palliative out-patient care (SAPV) legislation in 2007 palliative home care teams (PCTs) were established, providing holistic medical, nursing, and psychosocial support for patients with life-limiting illness and their care providers. OBJECTIVES: The article explores the role of GPs in palliative home care settings with PCTs from the patient's perspective...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
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