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Palliative pain

Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
William Breen, Irina Bancos, William F Young, Keith C Bible, Nadia N Laack, Robert L Foote, Christopher L Hallemeier
Purpose/Objectives: To evaluate the role of external beam radiation therapy (EBRT) for treatment of malignant paraganglioma (PGL) and pheochromocytoma (PCC). Methods and materials: A retrospective review was performed of all patients with malignant PGL/PCC treated with EBRT at our institution between 1973 and 2015. Local control (LC) per treated lesion and overall survival were estimated using the Kaplan-Meier method. Toxicities were scored using the Common Toxicity Criteria for Adverse Events (AE), version 4...
January 2018: Advances in Radiation Oncology
Tanya B Dorff, Neeraj Agarwal
Bone metastases are the main driver of morbidity and mortality in advanced prostate cancer. Targeting the bone microenvironment, a key player in the pathogenesis of bone metastasis, has become one of the mainstays of therapy in men with advanced prostate cancer. This review will evaluate the data supporting the use of bone-targeted therapy, including (1) bisphosphonates such as zoledronic acid, which directly target osteoclasts, (2) denosumab, a receptor activator of nuclear factor-kappa B (RANK) ligand inhibitor, which targets a key component of bone stromal interaction, and (3) radium-223, an alpha-emitting calcium mimetic, which hones to the metabolically active areas of osteoblastic metastasis and induces double-strand breaks in the DNA...
March 16, 2018: Asian Journal of Andrology
Vassilis Kouloulias, Evridiki Patriki, Eftychia Mosa, Kalliopi Platoni, John Georgakopoulos, Anna Zygogianni, Maria Dilvoi, George Patatoukas, Christos Antypas, Christina Armpilia, Nikolaos Trogkanis, Eyfrosini Kypraiou, Stella Nikoloudi, George Giannakouras, Efstathios Efstathopoulos, Nikolaos Kelekis, John Kouvaris
PURPOSE: To evaluate in an observational way the clinical impact of a hypofractionated irradiation schedule in patients with unresectable non-small cell lung cancer (NSCLC). METHODS: Forty elderly patients (24 men/16 women) diagnosed with unresectable stage IIIb/IV NSCLC unfit for chemotherapy, were treated with once-a-week hypofractionation schedule. All patients had a poor performance status. A dose of 255 Gy in 3 weekly fractions was prescribed while a 3D conformal technique (3D-CRT) was used for irradiation...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Rohit Gunan Ganju, Mindi TenNapel, Nicholas Mahan, Amir Zahra, Xinglei Shen
Background: There is little data regarding the effectiveness of palliative radiation with conventional fractionation for metastatic renal cell carcinoma (RCC), which has been described as radioresistant. We conducted a retrospective analysis of patients with metastatic bony disease from RCC treated with radiation therapy at our institution. Methods: Forty patients with histologically confirmed RCC with a total of 53 treatment courses were included. Pain response after radiotherapy was recorded and freedom from progression was generated using posttreatment radiographs...
2018: Journal of Oncology
Kenkichi Baba, Hayato Kaida, Chikayuki Hattori, Koichiro Muraki, Tomoko Kugiyama, Hiromasa Fujita, Masatoshi Ishibashi
OBJECTIVE: The purpose of this study was to investigate the palliative and tumoricidal effects of concurrent therapy of strontium-89 chloride (89 SrCl2 ) and zoledronic acid (ZA) for painful bone metastases. SUBJECTS AND METHODS: Fifty-one patients with painful bone metastases prostate cancer (n=17), lung cancer (n=13), breast cancer (n=12), other cancers (n=9) were treated. Bone metastases was confirmed in all patients by technetium-99m hydroxymethylene diphosphonate (99m Tc-HMDP) bone scintigraphy...
March 20, 2018: Hellenic Journal of Nuclear Medicine
Rosechelle M Ruggiero
The entity of chronic critical illness (CCI) has shown a rise in the past decades for popularity and prevalence. CCI is loosely defined as the group of patients who require the intensive care setting for weeks to months; its hallmark is prolonged mechanical ventilation. The outcomes of chronically critically ill patients have been dismal and have not improved over time; 1-year survival hovers at approximately 50%. Given the high mortality, prognostic variables are important when making medical decisions. CCI encompasses a syndrome that includes altered pathophysiology across a variety of organ systems...
March 2018: American Journal of the Medical Sciences
Marco Artico, Daniela D'Angelo, Michela Piredda, Tommasangelo Petitti, Luciano Lamarca, Maria Grazia de Marinis, Angelo Dante, Maura Lusignani, Maria Matarese
CONTEXT: Patients with advanced illnesses show the highest prevalence for pressure ulcers. In the palliative care setting the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. OBJECTIVES: To describe the course of healing for pressure ulcers in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement...
March 13, 2018: Journal of Pain and Symptom Management
Devin Vaswani, Adam N Wallace, Preston S Eiswirth, Thomas P Madaelil, Randy O Chang, Anderanik Tomasian, Jack W Jennings
PURPOSE: To evaluate the effectiveness of percutaneous image-guided thermal ablation in achieving local tumor control and pain palliation of sarcoma metastases within the musculoskeletal system. MATERIALS AND METHODS: Retrospective review of 64 sarcoma metastases within the musculoskeletal system in 26 women and 15 men (total = 41) treated with ablation between December 2011 and August 2016 was performed. Mean age of the cohort was 42.9 years ± 16.0 years...
March 14, 2018: Cardiovascular and Interventional Radiology
Muhammad Shuja, Ayman A Elghazaly, Asif Iqbal, Reham Mohamed, Amal Marie, Mutahir A Tunio, Moamen M Aly, Ali Balbaid, Mushabbab Asiri
Introduction Bone metastasis (BM) is a major complication of many solid tumors like breast, prostate, lung and renal cancers. BM leads to serious sequelae of pain, fractures, spinal cord compression and hypercalcemia. Radiotherapy has an established role in relieving pain caused by BM. Worldwide different radiotherapy schedules are being used for BM. The aim of this study is to determine the efficacy of single fraction palliative radiotherapy for painful bone metastases. Methods Between April 2014 and April 2017, single fraction radiotherapy was used to treat 73 patients in our institution...
January 8, 2018: Curēus
Mohan Giri, Mamata Giri, Rabin Jung Thapa, Bibhuti Upreti, Bijay Pariyar
Breast cancer is the second most common malignancy among Nepalese women. Breast cancer places a substantial burden on the Nepalese healthcare system, but information regarding the number of women living with breast cancer is not well recorded. In countries with lower levels of resources such as Nepal, breast cancers are commonly diagnosed at late stages and women may receive inadequate treatment, pain relief or palliative care. Socioeconomic disparities and insufficient financial resources hinder prevention of breast cancer in Nepal...
April 2018: Biomedical Reports
Myrick C Shinall, E Wesley Ely, Mohana Karlekar, Samuel G Robbins, Rameela Chandrasekhar, Sara F Martin
BACKGROUND: The Functional Assessment of Chronic Illness Therapy-Palliative (FACIT-Pal) 14 instrument measures the quality of life in palliative care patients but its psychometric properties are not well characterized. OBJECTIVES: To establish the reliability and validity of the FACIT-Pal 14 in an outpatient palliative care clinic population. METHODS: The FACIT-Pal 14 was administered to 227 patients in an outpatient palliative care clinic at a large, urban academic medical center...
January 1, 2018: American Journal of Hospice & Palliative Care
Mary M Mitchell, Eric D Hansen, Tuo-Yen Tseng, Meng Shen, Cynda Rushton, Tom Smith, Nancy Hutton, Jennifer Wolfe, Lee Bone, Jeanne Keruly, Lawrence Wissow, Amy R Knowlton
CONTEXT & OBJECTIVE: Advance care planning (ACP) rates remain low, especially among people who are HIV positive, disadvantaged, and African American. While ACP can be a sensitive topic for clinicians and patients to discuss, health values clarification can be an important initial step. METHODS: Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, MD, who had histories of illicit drug use...
March 8, 2018: Journal of Pain and Symptom Management
Ewa Zabrocka, Marek Z Wojtukiewicz, Ewa Sierko
Advanced cancer patients in hospice are at notably increased risk of venous thromboembolism (VTE) due to age, local and distal advancement of the malignancy and bed confinement, among other factors. Asymptomatic VTE prevalence among palliative care patients has been found to reach 50%, whereas the clinically overt form occurs in 10%. Hospice patients are frequently given medications increasing VTE risk, for instance megestrol which is a drug commonly used in cancer cachexia. Many of the available guidelines encourage the implementation of thromboprophylaxis (TPX) in cancer patients, e...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Yashika Garg, Jatinder Singh, H S Sohal, Rajeshwari Gore, Arun Kumar
OBJECTIVE: Osteoarthritis (OA) is a chronic progressive degenerative disease of weight-bearing joints and the leading cause of disability in elderly. Current medical management of OA is mostly palliative with nonsteroidal anti-inflammatory drugs (NSAIDs) being the mainstay of therapy. Reports of gastrointestinal adverse effects with traditional NSAIDs and cardiovascular adverse effects associated with selective cyclooxygenase-2 (COX-2) inhibitors have prompted the hunt for a better NSAID with no or minimal adverse effects...
September 2017: Indian Journal of Pharmacology
Vanessa Romotzky, Julia Strupp, Alexander Hayn, Jens Ulrich Rüffer, Judith Grümmer, Raymond Voltz
OBJECTIVE: We aimed to elucidate the views on life as narrated by patients in palliative care (PC) to find out what patients deem to be essential in their life, whether something has changed concerning their view of life in light of the disease, and whether interviewees would like to give others something to take with them. METHOD: Data were collected from narrative audio and video interviews with 18 inpatients in a specialized PC unit. Interviews were recorded and transcribed verbatim and analyzed using qualitative content analysis applying MAXQDA software...
March 8, 2018: Palliative & Supportive Care
Marie Nordström, Peter Strang
OBJECTIVE: At the initiative of Stockholm County Council, a survey was performed by an independent investigator to evaluate satisfaction among patients and their families with the advanced palliative home care teams in the county of Stockholm. The survey was performed in 2010 and compiled in 2011. The aim was to evaluate the impressions of patients and their families of the support given by the palliative home care teams in the Stockholm area and to evaluate the management of symptom control, availability, continuity, confidence, and quality of communication...
January 1, 2018: Journal of Palliative Care
Salimah H Meghani, Caroline Peterson, Donna H Kaiser, Joseph Rhodes, Hengyi Rao, Jesse Chittams, Anjan Chatterjee
BACKGROUND: Patients with cancer frequently experience physical and psychological distress that can worsen their quality of life. OBJECTIVES: We assessed the outcomes of an 8-week mindfulness-based art therapy (MBAT) intervention, Walkabout: Looking In, Looking Out, on symptoms, sleep quality, health-related quality of life, sense of coherence (SOC), and spirituality in outpatients with cancer. METHODS: A 1-group, pre-post intervention design with repeated measures at baseline, week 4, and week 8...
January 1, 2018: American Journal of Hospice & Palliative Care
Paolo Ceruti, Sara Lonni, Francesca Baglivo, Giampietro Marchetti
Malignant pleural mesothelioma (MPM) is an asbestos-related aggressive tumor, that requires proper diagnosis and management. Symptoms are nonspecific and chest computed tomography (CT) and chest ultrasound (US) are important radiological tools in the initial workup to identify early pathological signs. Performing a medical thoracoscopy (MT) is essential for a definitive diagnosis of MPM. The procedure, integrated with a prior US, allows a global evaluation of the pleural cavity and the execution of multiple targeted biopsies, with low risk of complications...
January 2018: Journal of Thoracic Disease
H Zhuang, Y Ma, L Wang, H Zhang
Background: Patients with metastatic non-small-cell lung cancer (nsclc) experience great pain and stress. Our study aimed to explore the effect of early palliative care on quality of life in patients with nsclc. Methods: A total of 150 patients were randomly divided into two groups: control group with conventional care and study group with early palliative care. The quality of life (qol) rating scale and self-rating scale of life quality (sslq) were used to analyze the patients' quality of life...
February 2018: Current Oncology
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