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Palliative therapy

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https://www.readbyqxmd.com/read/28810477/feasibility-randomised-controlled-trial-of-a-self-help-acceptance-and-commitment-therapy-intervention-for-grief-and-psychological-distress-in-carers-of-palliative-care-patients
#1
Esther L Davis, Frank P Deane, Geoffrey Cb Lyons, Gregory D Barclay, Joan Bourne, Vivienne Connolly
We tested the feasibility and preliminary effectiveness of an acceptance and commitment therapy self-help intervention for grief and psychological distress in carers of patients in palliative care. Carers were randomised to the control group, which received treatment as usual, or the intervention group, which received treatment as usual plus an acceptance and commitment therapy-based self-help booklet and telephone support call. Questionnaires were completed at baseline, 1-month post-allocation and 6 months post-loss...
June 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28809036/clinical-investigation-of-38-cases-of-oral-mucosal-melanoma-a-multicentre-retrospective-analysis-in-japan
#2
Shin-Ichi Yamada, Hiroshi Kurita, Takahiro Kamata, Tadaaki Kirita, Michihiro Ueda, Tetsuro Yamashita, Yoshihide Ota, Mitsunobu Otsuru, Nobuhiro Yamakawa, Masaya Okura, Tomonao Aikawa, Souichi Yanamoto, Masahiro Umeda
BACKGROUND/OBJECTIVES: The aim of the present study was to investigate treatment modalities and outcomes in oral mucosal melanoma. METHODS: The clinical and pathological data of 38 consecutive patients with oral mucosal melanoma were retrospectively analyzed. Patients' characteristics were analyzed and overall survival (OS) rates were calculated. RESULTS: Sixteen patients had stage III (42%), 19 IVA (50%), and three had stage IVC (8%) disease...
August 15, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#3
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28807365/-the-breakthrough-of-personalized-medicine-new-hopes-and-new-challenges
#4
REVIEW
Ronan Flippot, Christophe Massard, Edouard Auclin, David Azria, Héloïse Bourien, Philippe Rochigneux, Antoine Schernberg, Loïc Verlingue, Lara Zafrani, Stéphane Vignot
The development of personalized medicine in oncology is based on biomarkers that help select populations for more efficient and less toxic therapies. The onset of molecular biology led to new paradigms in drug development, with efficacy data reported in early clinical trials and accelerated approvals. Multiple clinical trials, including SHIVA, SAFIR-01 and MOSCATO-01, have been developed to evaluate the interest of treatment decision-making based on tumor molecular profiling, with the ambition to replace historical clinical and pathological classifications...
August 11, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28807235/stereotactic-ablative-radiation-therapy-in-renal-cell-carcinoma-from-oligometastatic-to-localized-disease
#5
REVIEW
Filippo Alongi, Stefano Arcangeli, Luca Triggiani, Rosario Mazzola, Michela Buglione di Monale E Bastia, Sergio Fersino, Anna Baiguini, Barbara Alicja Jereczek-Fossa, Stefano Maria Magrini
Renal Cell Carcinoma (RCC) has historically been considered a radioresistant cancer, and radiotherapy was usually delivered with a palliative goal. Stereotactic ablative radiotherapy (SABR) allows the delivery of high doses on small treatment volumes in a safe and effective way, thus opening the doors to new applicationsof radiotherapy both in the treatment of the primary and oligometastasic disease. Aim of the current review is to explore the state of art of SABR in the therapeutic approach to RCC.
September 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28805581/nonmotor-parkinson-s-and-future-directions
#6
Nataliya Titova, K Ray Chaudhuri
Nonmotor symptoms (NMS) of Parkinson's disease (PD) are integral to the condition largely regarded as a motor syndrome. A range of NMS underpin the prodromal stage of Parkinson's and are present with variable frequency, range, and nature across the whole journey of a patient with Parkinson's from the onset of the motor disease to palliative stage. These symptoms also are key determinants of quality of life of the patient as well as the carer. Despite this, recognition management and focused treatment of NMS of PD remain poor...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28805336/matrix-stimulation-in-cancer-pain-methodology-safety-and-effectiveness
#7
M Mücke, M Tils, R Conrad, D Kravchenko, H Cuhls, L Radbruch, M Marinova, V Peuckmann-Post, R Rolke
BACKGROUND: This feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low-frequency electrical stimulation (LFS). METHODS: Low-frequency matrix stimulation (4 Hz) was applied to the skin within the 'Head's zones' referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3-day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3-day follow-up period without therapy...
August 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#8
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804570/value-of-quality-of-life-analysis-in-liver-cancer-a-clinician-s-perspective
#9
REVIEW
Leung Li, Winnie Yeo
Health related quality of life (HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma (HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being...
July 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28803078/safety-and-effectiveness-of-palliative-drug-treatment-in-the-last-days-of-life-a-systematic-literature-review
#10
REVIEW
Kristian Jansen, Dagny Faksvåg Haugen, Lisa Pont, Sabine Ruths
CONTEXT: Dying patients commonly experience potentially distressing symptoms. Palliative care guidelines recommend opioids, anticholinergics, antipsychotics and benzodiazepines for symptom relief. OBJECTIVES: To systematically review the effectiveness and safety of palliative drug treatment in the last days of life of adult patients, focusing on the management of pain, dyspnea, anxiety, restlessness, and death rattle. METHODS: A systematic search of the literature published before December 2016 in PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane, ClinicalTrials...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802248/utility-of-rapid-whole-exome-sequencing-in-the-diagnosis-of-neonatal-niemann-pick-disease-type-c-presenting-with-fetal-hydrops-and-liver-failure
#11
Mersedeh Rohanizadegan, Sarah El-Almery, Anne O'Donnell-Luria, Ivana Mihalek, Peggy Chen, Marilyn Sanders, Kristen Leeman, Megan Cho, Christina Hung, Olaf Bodamer
Rapid whole exome sequencing (rWES) is increasingly used in critically ill newborn infants to inform about diagnosis, clinical management and prognosis. Here we report a male newborn infant with hydrops, pancytopenia and acute liver failure who was listed for liver transplantation. Given the acuity of the presentation, the procedure related morbidity and mortality and lack of diagnosis we employed rWES in the proband and both parents with a turn-around time of 10 business days. rWES returned one maternally inherited, likely pathogenic and one paternally inherited, likely pathogenic variant in NPC1 suggestive of a diagnosis of Niemann Pick disease type C (NPC)...
August 11, 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28800049/survival-outcomes-following-aggressive-treatment-of-oligometastatic-breast-cancer-a-systematic-review-protocol
#12
Robyn Coombe, Karolina Lisy, Jared Campbell, Gajen Perry, Subhita Prasannan
The objective of this systematic review is to assess the effectiveness of aggressive treatment of oligometastatic breast cancer (OMBC) on survival outcomes by conducting a meta-analysis of current available evidence.More specifically, the objectives are to identify the effectiveness of intensified multidisciplinary treatment with aggressive locoregional therapies on survival time, five-year survival rates and disease free survival. The population is adult women (18 years and over) with OMBC defined as single or few (five or less) metastases limited to a single organ and the comparative group is conventional palliative treatment aimed at disease control...
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28799457/a-single-institution-experience-for-the-management-of-recurrent-pleural-effusions-with-tunneled-pleural-catheter-and-its-evolution
#13
Tuhina Raman, Nikhil Meena
BACKGROUND: Indwelling tunneled pleural catheters (TPCs) are increasingly being used to treat recurrent pleural effusions. There is also an increased interest in early pleurodesis in order to prevent infectious complications. We studied the time to removal and other outcomes for all the TPCs placed at our institution. METHODS: After institutional review board approval, records of patients who had had a TPC placed between July 2009 and June 2016 were reviewed; the catheters were placed in an endoscopy suite or during pleuroscopy with or without a sclerosant...
August 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28796772/mortality-within-30-days-of-systemic-anticancer-therapy-at-a-tertiary-cancer-centre-assessing-the-safety-and-quality-of-clinical-care
#14
Michelle Wilson, Weng Mak, Melissa Firth, Sanjeev Deva, Michael Findlay
AIMS: Thirty-day mortality has been proposed to be a useful indicator of avoidable harm to patients from systemic anticancer therapies (SACT). As a quality assurance tool, we assessed the 30-day mortality rate at Auckland City Hospital and compared this with international standards. METHODS: Clinical characteristics and treatment details of medical oncology patients who died within 30 days of SACT from October 2014-September 2015 were collected and compared with data from a similar series performed from October 2008-September 2009...
August 11, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28792784/improved-pain-control-in-terminally-ill-cancer-patients-by-introducing-low-dose-oral-methadone-in-addition-to-ongoing-opioid-treatment
#15
Per Fürst, Staffan Lundström, Pål Klepstad, Sara Runesdotter, Peter Strang
BACKGROUND: Cancer pain is often not well controlled and there is a need for improved treatment strategies. Methadone exhibits unique properties among opioids and recent reports show promising results from adding a low dose of methadone to regular opioid therapy. OBJECTIVE: To examine the effects of oral low-dose methadone added to regular scheduled opioids in terminally ill patients with complex cancer-related pain. DESIGN: This was a retrospective chart review...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28783481/fosaprepitant-for-the-management-of-refractory-pain-in-a-patient-with-cancer-related-dermatomyositis
#16
Jennifer D Dulin, Patrick J Coyne, Nicole M Bohm, Mary Adler
OBJECTIVE: Optimal pain management often requires multiple pharmacological interventions with the goal of disrupting the pain-signaling pathway and targeting the underlying pathophysiology. Off label use of nonpain medications may have a role in treating refractory pain syndromes. BACKGROUND: We report a case of a 60-year-old female with refractory nociceptive and neuropathic pain. Conventional therapies were either ineffective or fraught with side effects. Given the underlying inflammatory nature of her pain syndrome, and the role of substance P (SP) in pain transmission and modulation, we decided to use fosaprepitant, an SP and neurokinin-1 (NK1) receptor antagonist...
August 7, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#17
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777677/my-kite-will-fly-improving-communication-and-understanding-in-young-children-when-a-mother-is-diagnosed-with-life-threatening-gynecological-cancer
#18
Cynthia Holland, Alison Hocking, Lynette Joubert, Fiona McDermott, Marcus D Niski, Frances Thomson Salo, Michael A Quinn
STUDY AIMS: The My Kite Will Fly (MKWF) research program is built on the well-documented need for effective clinical communication tools and therapeutic interventions where a child's mother is diagnosed with life-threatening gynecological cancer. METHODS: The Dignity Model and Child-Centered approach were two key study foundations in this pilot cohort. Quantitative survey and qualitative semistructured methods were employed to gather data from patient families at three distinct phases: Diagnosis, Treatment, and Palliative care...
August 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777648/ablation-of-musculoskeletal-metastases
#19
A Nicholas Kurup, Jonathan M Morris, Matthew R Callstrom
OBJECTIVE: The purpose of this article is to summarize the evidence supporting thermal ablation of musculoskeletal metastases on the basis of clinical application and to describe an approach to percutaneous ablative treatment, including patient workup, procedural strategy and techniques, and postablation follow-up. CONCLUSION: Percutaneous ablation of musculoskeletal metastases may result in significant pain palliation, prevention of morbidity from skeletal-related events, and local tumor control...
August 4, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#20
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
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