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Palliative pain

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https://www.readbyqxmd.com/read/29781824/symptom-experience-and-self-rated-physical-functioning-in-patients-with-ovarian-cancer-receiving-chemotherapy-a-longitudinal-study
#1
Ingvild Vistad, Milada Cvancarova, Guro Lindviksmoen Astrup, Tone Rustøen, Astrid H Liavaag
OBJECTIVES: In this longitudinal study, we investigated occurrence of multiple symptoms during chemotherapy in patients with ovarian cancer. We also evaluated whether self-rated physical functioning, selected demographic, and clinical variables were associated with symptom burden over time. METHODS AND MATERIALS: In total, 82 patients provided longitudinal data (4 time points) by completing questionnaires including the Memorial Symptom Assessment Scale, the Karnofsky Performance Status Scale, and the Self-Administered Comorbidity Questionnaire...
May 18, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29778742/management-of-paranasal-sinus-metastasis-by-percutaneous-ct-guided-permanent-seed-brachytherapy
#2
Stephen Doggett, Shigeru Chino, Todd Lempert, Kunal Sidhar
INTRODUCTION: A painful maxillary sinus metastasis in previously irradiated tissue required palliation. METHODS AND MATERIALS: Lesion was treated by computed tomography-guided palladium103 implantation as an outpatient procedure; the lesion and its attendant facial pain and swelling resolved completely. CONCLUSION: Computed tomography-guided permanent seed brachytherapy is a novel, rapid, effective, and low resource cost method of treating paranasal malignancy...
February 1, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29777846/an-academic-tertiary-referral-center-s-experience-with-a-vascular-surgery-based-uterine-artery-embolization-program
#3
Naiem Nassiri, Adrian Balica, Nolan C Cirillo-Penn, Dustin Tyler Crystal, Gloria A Bachmann
OBJECTIVE: Despite growing endovascular experience within the vascular surgery community, some catheter-based interventions - such as uterine artery embolization (UAE) - remain outside the clinical scope of most vascular surgeons, owing in part to established referral patterns and limited awareness among referring colleagues. We present our experience with a vascular surgery-based, multidisciplinary UAE program at an academic tertiary referral center. METHODS: In a collaborative effort between vascular surgery and gynecology, a Pelvic Vascular Disease Program has been established to provide palliative, prophylactic, and therapeutic embolizations including, but not limited to, UAE...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#4
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29775691/pain-in-maintenance-hemodialysis-patients-a-multicenter-study
#5
Tatiana Talya Fleishman, Jacob Dreiher, Pesach Shvartman
CONTEXT: Pain is a common complaint in maintenance hemodialysis (MHD) patients, yet is often inadequately assessed and undertreated. OBJECTIVES: To evaluate the prevalence, characteristics, intensity, and impact of pain in MHD patients. METHODS: In a cross-sectional study conducted between 2013 and 2015, 336 MHD patients from five hemodialysis units in hospitals owned by Clalit were interviewed and evaluated. Study tools included the Brief Pain Inventory, The Leeds Assessment of Neuropathic Symptoms and Signs pain scale, demographic and clinical characteristics...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29775550/palliative-sedation-with-oral-medicines-in-an-infant-with-generalized-severe-junctional-epidermolysis-bullosa
#6
Keith P Pasichow, Meg Frizzola, Elissa G Miller
Generalized severe junctional epidermolysis bullosa is a rare mechanobullous skin disorder that is uniformly fatal. We present the case of an infant who received palliative pain management and ultimately proportionate palliative sedation. However, because of the extent of the patient's skin disease, we were unable to provide palliative medication through parenteral routes. We discuss the provision of enteral palliative sedation, including the pharmacology, and creative use of medications to achieve sufficient palliation in this difficult and unique situation...
May 18, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29774894/value-of-diffusion-weighted-imaging-for-monitoring-tissue-change-during-magnetic-resonance-guided-high-intensity-focused-ultrasound-therapy-in-bone-applications-an-ex-vivo-study
#7
Sharon L Giles, Jessica M Winfield, David J Collins, Ian Rivens, John Civale, Gail R Ter Haar, Nandita M deSouza
Background: Magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) can palliate metastatic bone pain by periosteal neurolysis. We investigated the value of diffusion-weighted imaging (DWI) for monitoring soft tissue changes adjacent to bone during MR-guided HIFU. We evaluated the repeatability of the apparent diffusion coefficient (ADC) measurement, the temporal evolution of ADC change after sonication, and its relationship with thermal parameters. Methods: Ex-vivo experiments in lamb legs ( n = 8) were performed on a Sonalleve MR-guided HIFU system...
2018: European radiology experimental
https://www.readbyqxmd.com/read/29772922/behavioral-pain-intervention-for-hospice-and-palliative-care-patients-an-integrative-review
#8
Masako Mayahara, JoEllen Wilbur, Louis Fogg, Susan M Breitenstein
Despite the advances in pain management, achieving optimal pain control in hospice and palliative care is challenging. Patient/caregiver's lack of pain management knowledge, poor pain reporting, and poor adherence to pain management regimens are all associated with inadequate pain control. The purpose of this integrated review is to examine behavioral interventions designed for patients and caregivers to improve pain control in hospice and palliative care settings. Ten studies were identified through a database search...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29772281/geriatric-oncology-spirituality-and-palliative-care
#9
Lodovico Balducci
Cancer is a major cause of morbidity and mortality for older individuals. Palliative care is essential to improve the outcome of cancer treatment in terms of quality of life and treatment satisfaction. This review examines the influence of spirituality on aging in general and on the management of older cancer patients. A spiritual perspective has been associated with successful aging, and with better tolerance of physical and emotional stress, including the ability to cope with serious diseases and with isolation...
May 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#10
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29764822/numb-chin-syndrome-an-ominous-sign-of-mandibular-metastasis
#11
Abdul Razak, Bee See Goh, Jothi Raamahlingam Rajaran, Abd Jabar Nazimi
A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29764470/joint-preserving-palliative-surgery-using-self-locking-screws-of-intramedullary-nail-and-percutaneous-cementoplasty-for-proximal-humeral-metastasis-in-the-advanced-cancer-patients
#12
Jong Woong Park, Yong-Il Kim, Hyun Guy Kang, June Hyuk Kim, Han Soo Kim
BACKGROUND: We introduced a palliative joint-preserving surgery using proximal self-locking screws of intramedullary (IM) nail and percutaneous cementoplasty (PC) in patients with proximal humeral metastases, including the head and neck, and evaluated the outcome of the surgical method. METHODS: Twenty-three patients (mean age = 63.0 ± 11.8 years, M:F = 14:9) had IM nailing with a self-locking screw system and PC for the treatment of humeral head and neck metastases...
May 15, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29764182/the-use-of-ketamine-in-a-palliative-supportive-care-unit-a-retrospective-analysis
#13
Sebastiano Mercadante, Amanda Caruselli, Alessandra Casuccio
BACKGROUND: To assess the response to ketamine in patients with difficult pain syndromes. METHODS: The charts of patients with uncontrolled pain despite opioid dose escalation of at least two opioids or a combination of them, selected for a burst of ketamine and midazolam were reviewed. One hundred mg/day of ketamine and midazolam 15 mg/day by a continuous intravenous infusion for about 48 hours was offered to patients. RESULTS: Forty-four patients received a burst of ketamine...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29764181/symptom-clusters-using-the-eortc-qlq-c15-pal-in-palliative-radiotherapy
#14
Vithusha Ganesh, Liying Zhang, Bo Angela Wan, Leah Drost, May Tsao, Elizabeth Barnes, Carlo DeAngelis, Hans Chung, Patrick Diaz, Edward Chow
BACKGROUND: Patients with advanced cancer often experience a multitude of symptoms. Due to the potential interrelation of symptoms, symptom clusters of 2 or more concurrent symptoms have been advocated for use in the palliative setting to provide better management of symptoms. METHODS: The principal component analysis (PCA), exploratory factor analysis (EFA) and hierarchal cluster analysis (HCA) were conducted on responses to items 1-14 in the European Organisation for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC QLQ-C15-PAL) at baseline and days 5 and 10 following RT...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29764173/developing-palliative-care-programs-in-indigenous-communities-using-participatory-action-research-a-canadian-application-of-the-public-health-approach-to-palliative-care
#15
Mary Lou Kelley, Holly Prince, Shevaun Nadin, Kevin Brazil, Maxine Crow, Gaye Hanson, Luanne Maki, Lori Monture, Christopher J Mushquash, Valerie O'Brien, Jeroline Smith
BACKGROUND: The Indigenous people of Canada include First Nations, Inuit and Metis. This research focused on four diverse First Nations communities located in Ontario and Manitoba. First Nations communities have well-established culturally-based social processes for supporting their community members experiencing dying, loss, grief and bereavement. However, communities do not have formalized local palliative care (PC) programs and have limited access to medical services, especially pain and symptom management...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29763984/laparoscopic-versus-open-approach-to-neurolytic-celiac-plexus-block-in-inoperable-pancreatic-cancer
#16
Kostas Tepelenis, Konstantinos E Tsimogiannis, Nikolaos Zikos, Spyridon Koulas, George Pappas-Gogos, Nikolaos Benetatos, Ioannis Tsimogiannis, Evangelos C Tsimoyiannis
BACKGROUND: Neurolytic celiac plexus block (NCPB) is an effective method of palliative pain control. The purpose of this study was to evaluate the feasibility and effectiveness of the laparoscopic NCPB versus open approach. METHODS: Eight patients (Group A) underwent diagnostic laparoscopy which revealed an inoperable pancreatic cancer. Forty millilitres of solution (20 mL of 95% ethanol mixed with 20 mL of xylocaine) was injected into either side of para-aortic soft tissue...
May 15, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29762260/clinical-indications-associated-with-opioid-initiation-for-pain-management-in-ontario-canada-a-population-based-cohort-study
#17
Sachin V Pasricha, Mina Tadrous, Wayne Khuu, David N Juurlink, Muhammad M Mamdani, J Michael Paterson, Tara Gomes
Concerns over prescription opioids contributing to high levels of opioid use disorder and overdose have led policymakers and clinicians to seek means to reduce inappropriate and high-dose initial prescriptions. To inform such efforts, we sought to describe the clinical indications associated with opioid initiation and the characteristics of the initial prescriptions and patients through a retrospective population-based cohort study. Our cohort included Ontarians initiating prescription opioids for pain management between April 1, 2015, and March 31, 2016...
May 14, 2018: Pain
https://www.readbyqxmd.com/read/29756612/cancer-of-the-head-and-neck-a-set-of-indicators-based-on-register-and-administrative-data
#18
A Andreano, M Ansarin, D Alterio, R Bruschini, M G Valsecchi, A G Russo
Head and neck (H&N) tumours are a heterogeneous group of neoplasms with 5-year relative survival ranging from about 25% for the hypopharynx to 60% for the larynx in Europe. To improve survival rates, along with therapeutic improvements, it is important to standardise and optimise care received by patients with H&N tumours across different healthcare providers. To reach this goal, it is necessary to evaluate adherence to standards of received care at a population level. Published guidelines can serve as the basis to develop indicators, which can be computed from administrative health databases, measuring the adherence to specific recommendations at the individual level in unselected H&N cancer patients, identified from a population cancer register...
February 2018: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29750984/liquid-nitrogen-spray-cryotherapy-for-dysphagia-palliation-in-patients-with-inoperable-esophageal-cancer
#19
Toufic Kachaamy, Ravi Prakash, Madappa Kundranda, Raman Batish, Jeffrey Weber, Scott Hendrickson, Leon Yoder, Hannah Do, Theresa Magat, Rajeev Nayar, Digant Gupta, Trisha DaSilva, Ashish Sangal, Shivangi Kothari, Vivek Kaul, Pankaj Vashi
BACKGROUND AND AIMS: Dysphagia is a debilitating symptom in patients with inoperable esophageal cancer contributing to poor quality of life and worsening nutritional status. The 2 most commonly used palliative modalities for dysphagia are radiation therapy (RT) and esophageal stent placement. However, RT is limited by adverse events (AEs) and total dose, and stent placement has a high rate of AEs including reflux, migration, and chest pain. A relatively new modality of liquid nitrogen endoscopic spray cryotherapy has been described as salvage when other options have been exhausted and when patients are no longer receiving systemic therapy...
May 8, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29743120/cavernous-sinus-involvement-in-human-papillomavirus-associated-oropharyngeal-squamous-cell-carcinoma-case-report-of-an-atypical-site-of-distant-metastasis
#20
David Forner, Derek Wilke, Matthew H Rigby, Sidney Croul, Anuradha Mishra, Emad Massoud, David B Clarke, Nathan Lamond
BACKGROUND: HPV-associated OSCC (HPV-OSCC) has been determined to be a distinct disease entity from non-HPV associated OSCC. Patients affected by HPV-OSCC generally have a more favourable prognosis, with improved rates of locoregional control and survival compared with their non-HPV counterparts. Despite this, HPV-OSCC has a similar rate of distant metastases. Interestingly, recent evidence has emerged that demonstrates more frequent atypical metastasis patterns when compared to non-HPV associated disease...
May 9, 2018: Journal of Otolaryngology—Head & Neck Surgery
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