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https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#1
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28730759/surgical-treatment-for-colorectal-cancer-in-octogenarians-and-nonagenarians
#2
Young Wan Kim
Advances in surgical techniques and perioperative care have improved cancer-related outcomes. However, there are still concerns regarding the safety of octogenarian and nonagenarian patients during surgery. Clinicians may be reluctant to perform a radical resection for colorectal cancer and administer adjuvant or palliative cytotoxic chemotherapy to octogenarian and nonagenarian patients. In the elderly, setting a primary goal based on multidisciplinary team discussions prior to treatment is important. The overall treatment scheme, risks, and potential benefits should be discussed with elderly patients and their families...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28728515/the-prevalence-of-constipation-at-admission-and-after-one-week-of-palliative-care-a-multicenter-study
#3
Sebastiano Mercadante, Francesco Masedu, Marco Maltoni, Daniela De Giovanni, Luigi Montanari, Cristina Pittureri, Raffaella Bertè, Laura Ursini, Franco Marinangeli, Federica Aielli
AIM: To assess the prevalence and intensity of constipation in advanced-cancer patients referred to palliative care, and to assess changes after one week of specialist palliative care. METHODS: Prospective multicenter study in advanced patients for a period of one year. At admission (T0), age, gender, primary tumor, concomitant diseases, Karnofsky status, Palliative prognostic score (PaP) Edmonton Symptom Assessment scale (ESAS), MDAS (Memorial Delirium Assessment Scale), and bowel function index (BFI) were collected...
July 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28723252/across-the-continuum-how-inpatient-palliative-care-consultations-are-reported-in-hospital-discharge-summaries
#4
Nikki Miller, John Shuler, Deon Hayley, Jianghua He, Karin Porter-Williamson, Jessica Kalender-Rich
BACKGROUND: Inpatient Palliative Care (PC) consultations help develop a patient-centered and quality-of-life-focused plan of care for patients with serious illness. Discharge summaries (DSs) are an essential tool to maintain continuity of these care plans across multiple locations and providers. METHODS: We conducted a retrospective chart review of selected DSs of patients who received inpatient PC consultations at the University of Kansas Hospital from July 2011 to May 2015...
July 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28722811/barriers-to-palliative-care-in-people-with-chronic-obstructive-pulmonary-disease-in-home-care-a-qualitative-study-of-the-perspective-of-professional-caregivers
#5
Camilla Askov Mousing, Helle Timm, Kirsten Lomborg, Marit Kirkevold
AIMS AND OBJECTIVES: To examine the experiences with palliative care in people with chronic obstructive pulmonary disease among professional caregivers in a Danish home care setting. BACKGROUND: Many patients with advanced chronic obstructive pulmonary disease (COPD) depend on professional caregivers in the primary sector to provide assistance and care. However, COPD patients receive no or only very little palliative care compared to patients with cancer although they may have many burdensome symptoms...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28721899/gaps-in-radiation-therapy-awareness-results-from-an-educational-multi-institutional-survey-of-us-internal-medicine-residents
#6
Narek Shaverdian, Sun Mi Yoo, Ryan Cook, Eric M Chang, Naomi Jiang, Ye Yuan, Kiri Sandler, Michael Steinberg, Percy Lee
PURPOSE: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. METHODS AND MATERIALS: A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28720612/translating-staff-experience-into-organisational-improvement-the-heads-up-stepped-wedge-cluster-controlled-non-randomised-trial
#7
Samuel Pannick, Thanos Athanasiou, Susannah J Long, Iain Beveridge, Nick Sevdalis
OBJECTIVES: Frontline insights into care delivery correlate with patients' clinical outcomes. These outcomes might be improved through near-real time identification and mitigation of staff concerns. We evaluated the effects of a prospective frontline surveillance system on patient and team outcomes. DESIGN: Prospective, stepped wedge, non-randomised, cluster controlled trial; prespecified per protocol analysis for high-fidelity intervention delivery. PARTICIPANTS: Seven interdisciplinary medical ward teams from two hospitals in the UK...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28719997/the-benefit-of-evolving-multidisciplinary-care-in-als-a-diagnostic-cohort-survival-comparison
#8
Sarah Martin, Emma Trevor-Jones, Sabyha Khan, Keelan Shaw, Deepti Marchment, Anna Kulka, Catherine E Ellis, Rachel Burman, Martin R Turner, Liam Carroll, Leah Mursaleen, P Nigel Leigh, Christopher E Shaw, Neil Pearce, Daniel Stahl, Ammar Al-Chalabi
BACKGROUND: Care for people with amyotrophic lateral sclerosis (ALS) has altered at King's College Hospital over the last 20 years. The clinic has been a multidisciplinary, specialist, tertiary referral centre since 1995 with a large team with integrated palliative and respiratory care since 2006. We hypothesised that these changes would improve survival. METHODS: In this retrospective observational study, patients diagnosed with El Escorial definite, probable and possible ALS between 1995-1998 and 2008-2011 were followed up...
July 18, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#9
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716613/a-novel-use-of-peer-coaching-to-teach-primary-palliative-care-skills-coaching-consultation
#10
Juliet Jacobsen, Corrine Alexander-Cole, Bethany-Rose Daubman, Dejani Banerji, Joe Greer, Karen o'Brien, Kathleen Doyle, Vicki Jackson
BACKGROUND: We aim to address palliative care workforce shortages by teaching clinicians how to provide primary palliative care through peer coaching. INTERVENTION: We offered peer coaching to internal medicine residents and hospitalists (attendings, nurse practioners, and physician assistants). MEASUREMENTS: An audit of peer coaching encounters and coachee feedback to better understand the applicability of peer coaching in the inpatient setting to teach primary palliative care...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28712277/moderate-hypofractionated-image-guided-thoracic-radiotherapy-for-locally-advanced-node-positive-non-small-cell-lung-cancer-patients-with-very-limited-lung-function-a-case-report
#11
Farkhad Manapov, Olarn Roengvoraphoj, Minglun Li, Chukwuka Eze
Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second [FEV1] ≤ 1 L) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes...
June 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28711371/extubation-to-high-flow-nasal-cannula-in-critically-ill-surgical-patients
#12
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Danielle Polevoi, Richard Liang, Galinos Barmparas, Eric J Ley
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used to reduce reintubations in patients with respiratory failure. Benefits include providing positive end expiratory pressure, reducing anatomical dead space, and decreasing work of breathing. We sought to compare outcomes of critically ill surgical patients extubated to HFNC versus conventional therapy. METHODS: A retrospective review was conducted in the surgical intensive care unit of an academic center during August 2015 to February 2016...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28708751/use-of-non-pharmacological-interventions-for-comforting-patients-in-palliative-care-a-scoping-review
#13
Adriana Coelho, Vítor Parola, Daniela Cardoso, Miguel Escobar Bravo, João Apóstolo
BACKGROUND: Palliative care aims to provide the maximum possible comfort to people with advanced and incurable diseases. The use of non-pharmacological interventions to promote comfort in palliative care settings has been increasing.However, information on implemented and evaluated interventions, their characteristics, contexts of application, and population is scattered in the literature, hampering the formulation of accurate questions on the effectiveness of those interventions and, consequently, the development of a systematic review...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28708236/psychosocial-interventions-for-fatigue-during-cancer-treatment-with-palliative-intent
#14
REVIEW
Hanneke Poort, Marlies Peters, Gijs Bleijenberg, Marieke Fm Gielissen, Martine Margaretha Goedendorp, Paul Jacobsen, Stans Verhagen, Hans Knoop
BACKGROUND: Fatigue is a prevalent and burdensome symptom for patients with incurable cancer receiving cancer treatment with palliative intent and is associated with reduced quality of life. Psychosocial interventions seem promising for management of fatigue among cancer patients. OBJECTIVES: To assess the effects of psychosocial interventions for fatigue in adult patients with incurable cancer receiving cancer treatment with palliative intent. SEARCH METHODS: We searched the following databases: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, and seven clinical trial registries; we also searched the reference lists of articles...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28707168/acupuncture-for-cancer-related-fatigue-in-lung-cancer-patients-a-randomized-double-blind-placebo-controlled-pilot-trial
#15
Chien-Shan Cheng, Lian-Yu Chen, Zhou-Yu Ning, Chen-Yue Zhang, Hao Chen, Zhen Chen, Xiao-Yan Zhu, Jing Xie
BACKGROUND: Cancer-related fatigue (CRF) is a distressing symptom that is the most common unpleasant side effect experienced by lung cancer patients and is challenging for clinical care workers to manage. METHODS: We performed a randomized, double-blind, placebo-controlled pilot trial to evaluate the clinical effect of acupuncture on CRF in lung cancer patients. Twenty-eight patients presenting with CRF were randomly assigned to active acupuncture or placebo acupuncture groups to receive acupoint stimulation (LI-4, Ren-6, St-36, KI-3, and Sp-6) twice per week for 4 weeks, followed by 2 weeks of follow-up...
July 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28705314/palliative-care-in-heart-failure-the-pal-hf-randomized-controlled-clinical-trial
#16
Joseph G Rogers, Chetan B Patel, Robert J Mentz, Bradi B Granger, Karen E Steinhauser, Mona Fiuzat, Patricia A Adams, Adam Speck, Kimberly S Johnson, Arun Krishnamoorthy, Hongqiu Yang, Kevin J Anstrom, Gwen C Dodson, Donald H Taylor, Jerry L Kirchner, Daniel B Mark, Christopher M O'Connor, James A Tulsky
BACKGROUND: Advanced heart failure (HF) is characterized by high morbidity and mortality. Conventional therapy may not sufficiently reduce patient suffering and maximize quality of life. OBJECTIVES: The authors investigated whether an interdisciplinary palliative care intervention in addition to evidence-based HF care improves certain outcomes. METHODS: The authors randomized 150 patients with advanced HF between August 15, 2012, and June 25, 2015, to usual care (UC) (n = 75) or UC plus a palliative care intervention (UC + PAL) (n = 75) at a single center...
July 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28705009/palliative-care-and-advance-care-planning-for-pancreas-and-other-cancers
#17
Rajiv Agarwal, Andrew S Epstein
The principles of palliative care are fundamental to support and treat the physical, mental, and psychosocial health of patients living with pancreatic cancer. In addition to its proven advantages to help manage disease-related symptoms, improve accurate illness understanding, and enhance the quality of life and survival outcomes for patients with advanced disease, the inclusion of palliative care principles (whether by a specialist or by the primary oncology team) with standard oncologic care strengthens timely and quality advance care planning (ACP)...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28699144/palliative-care-needs-assessment-in-the-neuro-icu-effect-on-family
#18
Claire J Creutzfeldt, Marina G Hanna, C Sherry Cheever, Abhijit V Lele, Charles Spiekerman, Ruth A Engelberg, J Randall Curtis
BACKGROUND: Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU). METHODS: We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds...
July 11, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28697523/-assessment-of-idc-pal-as-a-diagnostic-tool-for-family-physicians-to-identify-patients-with-complex-palliative-care-needs-in-germany-a-pilot-study
#19
María Rosa Salvador Comino, Victor Regife Garcia, Maria Auxiliadora Fernández López, Berend Feddersen, María Luisa Martin Roselló, Linda Sanftenberg, Jörg Schelling
Background Palliative medicine is an essential component of the health care system. Basic palliative care should be provided by primary care services (family physician and home nursing) with palliative-medical basic qualification. Often it is very difficult to identify patients that would profit from a specialized palliative care team. For the evaluation of the case complexity of a palliative patient, we present a Spanish diagnostic tool IDC-Pal, which tries to specify when, why and where a palliative patient should be referred...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28696624/-it-all-started-with-a-simple-symptom-and-then%C3%A2-basic-palliative-medical-tools-for-primary-care-physicians
#20
Christophe Dulong De Rosnay, Tony Tai, Olivier Pasche
The treatment of symptoms in palliative care is of primary importance, though this in itself is not sufficient for the relief of all aspects of a patient's suffering. Pain, dyspnea, or anxiety cannot be reduced to a single somatic characteristic, the psychological implications and the consequences on the patient's daily life being of paramount importance. A respect with regard to certain basic principles, and a full knowledge of the main therapeutic approaches available, allow for a better initial management of the symptoms...
November 2, 2016: Revue Médicale Suisse
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