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End-of-life sedation

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https://www.readbyqxmd.com/read/28854065/efficacy-of-thalidomide-in-preventing-delayed-nausea-and-vomiting-induced-by-highly-emetogenic-chemotherapy-a-randomized-multicenter-double-blind-placebo-controlled-phase-iii-trial-clog1302-study
#1
Lingyun Zhang, Xiujuan Qu, Yuee Teng, Jing Shi, Ping Yu, Tao Sun, Jingyan Wang, Zhitu Zhu, Xiuna Zhang, Mingfang Zhao, Jing Liu, Bo Jin, Ying Luo, Zan Teng, Yuyang Dong, Fugang Wen, Yuzhi An, Caijun Yuan, Tiejun Chen, Lizhong Zhou, Ying Chen, Jian Zhang, Zhenghua Wang, Jinglei Qu, Feng Jin, Jingdong Zhang, Xiuhua Jin, Xiaodong Xie, Jun Wang, Li Man, Lingyu Fu, Yunpeng Liu
Purpose We examined the efficacy and safety of thalidomide (THD) for the prevention of delayed nausea and vomiting in patients who received highly emetogenic chemotherapy (HEC). Patients and Methods In a randomized, double-blind, active-controlled, phase III trial, chemotherapy-naive patients with cancer who were scheduled to receive HEC that contained cisplatin or cyclophosphamide-doxorubicin/epirubincin ≥ 50 mg/m(2) regimens were randomly assigned to a THD group (100 mg twice daily on days 1 to 5) or placebo group, both with palonosetron (0...
August 30, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28832240/-was-it-worth-it-intrathecal-analgesia-for-cancer-pain-a-qualitative-study-exploring-the-views-of-family-carers
#2
Nishi Patel, Melanie Huddart, Helen Makins, Theresa Mitchell, Jane L Gibbins, Juan Graterol, Deborah Stevens, Paul Perkins
BACKGROUND: Intrathecal drug delivery is known to reduce pain in patients where conventional systemic analgesia has been ineffective or intolerable. However, there is little information regarding the effects of intrathecal drug delivery on quality of life and function in those with advanced, incurable cancer. AIM: Retrospective exploration of the views of bereaved carers regarding the physical and psychosocial effects of external tunnelled intrathecal drug delivery in patients with advanced incurable cancer...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28810438/patients-with-limited-communication-in-end-of-life-situations-initial-psychometric-properties-of-a-discomfort-observation-scale
#3
Ana Lucila Soto-Rubio, José Manuel Tomás Miguel, Marián Pérez-Marín, Pilar Barreto Martín
This work presents an observational scale which takes into account different observable indicators of discomfort of patients in end-of-life situations with difficulties in communicating due to cognitive impairment, fatigue or sedation and provides details of its validation. In all, 71 adults participated. Model fit was adequate ( χ(2)(27) = 43.28, p = .024, comparative fit index = .975, root mean square error of approximation = .092 and confidence interval 90% (.033-.140)). Alpha coefficient was ...
March 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28803083/the-impact-of-combined-use-of-opioids-antipsychotics-and-anxiolytics-on-survival-in-the-hospice-setting
#4
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Aleksandar Čubranić
CONTEXT: Opioids and sedatives are the cornerstone of symptom management in the end-of-life patients, but undertreatment is a common problem. Although several studies explored the individual effect of opioids, anxiolytics and antipsychotics on survival, not much is known regarding their combined use. As these drugs share similar and potentially fatal side effects, primarily respiratory depression which occurs more often during night-hours, it is crucial to explore whether their interaction poses a danger for fragile hospice patients...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28735270/subcutaneous-levetiracetam-for-the-management-of-seizures-at-the-end-of-life
#5
REVIEW
Anna Elizabeth Sutherland, John Curtin, Victoria Bradley, Olivia Bush, Maggie Presswood, Victoria Hedges, Katrien Naessens
OBJECTIVES: To report the results of a combined case series analysis of subcutaneous levetiracetam (Keppra) for the management of seizures in palliative care patients. METHODS: A comprehensive literature review on the use of subcutaneous levetiracetam was performed, and these data were combined with a prospective observational audit of its use in terminal care undertaken in a regional palliative care network. RESULTS: 7 papers were identified from the literature review-four case reports and three observational case series-reporting on a total of 53 cases where subcutaneous levetiracetam was administered...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28716475/fouling-assemblage-of-benthic-plastic-debris-collected-from-mersin-bay-ne-levantine-coast-of-turkey
#6
Sedat Gündoğdu, Cem Çevik, Serkan Karaca
The Mediterranean is an ecosystem that faces more and more microplastic pollution every day. This causes the whole of the Mediterranean to face the negative effects of plastic pollution. This study examines the state of plastic debris and fouling organisms found on it in one of the areas most affected by plastic pollution, Mersin Bay. As a result, a total of 3.88kg plastic (mean=0,97kg; n=120; 2670item/km(2); 86,3kg/km(2)) was collected and based on the ATR-FTIR analysis, it was determined that this total contained 9 types of plastics...
July 14, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/28715310/discovering-ways-to-mend-growing-bodies-the-bioengineering-of-devices-for-the-youngest-patients-brings-unique-challenges-and-rewards
#7
David L Chandler
Some babies are born with a rare condition known as esophageal atresia, in which part of the connection between the throat and stomach is missing or nonfunctional. While this was once untreatable and fatal, in recent years surgeons have developed a method using traction to stretch the tissues out on each end until, over time, they are long enough to be sewn together and so substitute for the missing portion of the esophagus. The procedure has allowed many infant patients to go home with a full, normal life ahead of them...
July 2017: IEEE Pulse
https://www.readbyqxmd.com/read/28662627/continuous-palliative-sedation-for-existential-distress-a-survey-of-canadian-palliative-care-physicians-views
#8
Anna Voeuk, Cheryl Nekolaichuk, Robin Fainsinger, Ann Huot
BACKGROUND: Palliative sedation can be used for refractory symptoms during end-of-life care. However, continuous palliative sedation (CPS) for existential distress remains controversial due to difficulty determining when this distress is refractory. OBJECTIVES: The aim was to determine the opinions and practices of Canadian palliative care physicians regarding CPS for existential distress. METHODS: A survey focusing on experience and views regarding CPS for existential distress was sent to 322 members of the Canadian Society of Palliative Care Physicians...
January 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28602377/end-of-life-care-in-the-treatment-of-heart-failure-in-older-adults
#9
REVIEW
John Arthur McClung
Heart failure presents unique challenges to the clinician who desires to provide excellent and humane care near the end of life. Accurate prediction of mortality in the individual patient is complicated by a chronic disease that is punctuated by recurrent acute episodes and sudden death. Health care providers continue to have difficulty communicating effectively with terminally ill patients and their caregivers regarding end-of-life care preferences, all of which needs to occur earlier rather than later. This article also discusses various means of providing palliative care, and specific issues regarding device therapy, cardiopulmonary resuscitation, and palliative sedation with concurrent discussion of the ethical ramifications and pitfalls of each...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601143/psychiatric-and-palliative-care-in-the-intensive-care-unit
#10
REVIEW
Stephanie M Harman
Palliative care is specialized medical care focused on patients with serious illness and their families. In the intensive care unit (ICU), palliative care encompasses core skills to support patients and their families throughout their ICU course and post-ICU stays. Psychiatric symptoms are common among patients approaching the end of life and require particular attention in the setting of sedating medications, typically used when patients require ventilators and other life-sustaining treatments. For patients with preexisting severe mental illness who have a concurrent serious medical illness, a palliative psychiatric approach can address complex symptom management and support ethical and value-based shared decision making...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28511598/silexan-in-anxiety-disorders-clinical-data-and-pharmacological-background
#11
Siegfried Kasper, Walter E Müller, Hans-Peter Volz, Hans-Jürgen Möller, Egon Koch, Angelika Dienel
OBJECTIVES: Silexan is a lavender oil preparation available in 80-mg capsules. Here we review clinical trials investigating its anxiolytic efficacy, safety and tolerability in humans, as well as preclinical investigations supporting this therapeutic use. METHODS: Besides three selected publications reporting preclinical investigations, seven clinical trials are included, of which five had a treatment duration of 6 or 10 weeks. Primary outcome measure was the HAM-A total score reduction, while single items were assessed with regard to effects on concomitant depressive symptoms and on quality of sleep...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28511488/comparative-efficacy-and-safety-of-ebastine-20-mg-ebastine-10-mg-and-levocetirizine-5-mg-in-acute-urticaria
#12
Vippan Goyal, Anu Gupta, Onam Gupta, Dhruvendra Lal, Manharan Gill
INTRODUCTION: Acute and chronic urticaria can result in severely impaired quality of life from pruritus and associated sleep lessness, as well as anxiety and depression. Various treatment modalities are available out of which second generation non sedating H1 antihistamines e.g., fexofenadine, loratidine, desloratadine, cetirizine, levocetirizine, ebastine etc., are used as the first line treatment. AIM: To compare the safety and efficacy of ebastine 20 mg, ebastine 10 mg and levocetirizine 5 mg in the patients of urticaria...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28501039/symptomatic-control-in-end-of-life-patients
#13
REVIEW
Mariana Alves, Rita Abril, Isabel Galriça Neto
End-of-life patients present a variety of symptoms that cause suffering for them and their respective families. Health professionals throughout their university, internship and medical careers are ill-prepared to manage and improve the quality of life of these patients. This article aims to provide basic skills in the symptomatic management of end-of-life patients, focusing in particular on the control of pain, dyspnoea, fatigue, nausea, vomiting and anorexia. It also aims to draw attention to basic concepts of control concerning refractory symptoms and palliative sedation...
January 31, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28482856/the-impact-of-the-inpatient-practice-of-continuous-deep-sedation-until-death-on-healthcare-professionals-emotional-well-being-a-systematic-review
#14
REVIEW
Sarah Ziegler, Hannes Merker, Margareta Schmid, Milo A Puhan
BACKGROUND: The practice of continuous deep sedation is a challenging clinical intervention with demanding clinical and ethical decision-making. Though current research indicates that healthcare professionals' involvement in such decisions is associated with emotional stress, little is known about sedation-related emotional burden. This study aims to systematically review the evidence on the impact of the inpatient practice of continuous deep sedation until death on healthcare professionals' emotional well-being...
May 8, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#15
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28342436/-vulnerations-of-human-dignity-at-the-end-of-life
#16
Roberto Germán Zurriaráin
Death is constitutive of human nature and therefore it must happen naturally. But there are mainly two ways that falsify it: euthanasia and therapeutic obstinacy. Two wrong choices that do not accept the human reality of death (the first, anticipates death and the second, delays it). From the philosophical and ethical point of view, both options are rejected, because they are against human dignity at the end of life. Aside from these, this article also rejects the different names which are given to refer to euthanasia, that also go against human nature at the end of life...
January 2017: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/28315010/comparison-of-efficacy-of-meperidine-and-fentanyl-in-terms-of-pain-management-and-quality-of-life-in-patients-with-cervical-cancer-receiving-intracavitary-brachytherapy-a-double-blind-randomized-controlled-trial
#17
Saengrawee Thanthong, Sirikorn Rojthamarat, Wipra Worasawate, Phongthara Vichitvejpaisal, Danupon Nantajit, Nantakarn Ieumwananontachai
OBJECTIVE: The aim of this study was to compare the effectiveness of two sedative regimens, a benzodiazepine with either meperidine or fentanyl, in relieving pain in patients with cervical cancer undergoing intracavitary brachytherapy in terms of pain score and quality of life. METHODS: Forty unselected outpatients undergoing brachytherapy (160 fractions) were enrolled with informed consent and randomized to receive a benzodiazepine with either meperidine or fentanyl...
March 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28287357/a-review-of-agents-for-palliative-sedation-continuous-deep-sedation-pharmacology-and-practical-applications
#18
REVIEW
John Bodnar
Continuous deep sedation at the end of life is a specific form of palliative sedation requiring a care plan that essentially places and maintains the patient in an unresponsive state because their symptoms are refractory to any other interventions. Because this application is uncommon, many providers may lack practical experience in this specialized area and resources they can access are outdated, nonspecific, and/or not comprehensive. The purpose of this review is to provide an evidence- and experience-based reference that specifically addresses those medications and regimens and their practical applications for this very narrow, but vital, aspect of hospice care...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28256814/palliative-sedation-a-feasible-option-to-improve-end-of-life-care-in-seriously-ill-dying-patients
#19
Paolo Cotogni, Luca Brazzi
No abstract text is available yet for this article.
March 3, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#20
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
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