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https://www.readbyqxmd.com/read/29330226/mitotane-treatment-in-patients-with-metastatic-testicular-leydig-cell-tutor-associated-with-severe-androgen-excess
#1
Vasileios Chortis, Nicholas J Johal, Irina Bancos, Matthew Evans, Kassiani Skordilis, Peter Guest, Michael H Cullen, Emilio Porfiri, Wiebke Arlt
Mitotane (o,p'DDD) is established in the adjuvant and advanced stage treatment of adrenocortical carcinoma and counteracts both tumour growth and tumour-related steroid production. Both the adrenal glands and the gonads are steroidogenically active organs and share a common embryogenic origin. Here we describe the effects of mitotane in two patients with metastatic Leydig cell tumour (LCT) of the testes and associated severe androgen excess (serum testosterone 93 and 88 nmol/l, respectively; male reference range 7-27 nmol/L)...
January 12, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29323617/differential-effects-of-early-palliative-care-based-on-the-age-and-sex-of-patients-with-advanced-cancer-from-a-randomized-controlled-trial
#2
Ryan D Nipp, Areej El-Jawahri, Lara Traeger, Jamie M Jacobs, Emily R Gallagher, Elyse R Park, Vicki A Jackson, William F Pirl, Jennifer S Temel, Joseph A Greer
BACKGROUND: Early palliative care interventions enhance patient outcomes, including quality of life, mood, and coping, but it remains unclear whether certain subgroups of patients are more likely to benefit from early palliative care. We explored whether age and sex moderate the improved outcomes seen with early palliative care. METHODS: We performed a secondary analysis of data from a randomized trial of 350 patients with advanced lung and non-colorectal gastrointestinal cancer...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29317145/evaluation-of-quality-of-life-outcomes-following-palliative-treatment-of-bone-metastases-with-magnetic-resonance-guided-high-intensity-focused-ultrasound-an-international-multicentre-study
#3
D Harding, S L Giles, M R D Brown, G R Ter Haar, M van den Bosch, L W Bartels, Y-S Kim, M Deppe, N M deSouza
AIMS: To determine quality of life (QoL) outcomes after palliation of pain from bone metastases using magnetic resonance-guided high intensity focused ultrasound (MR-guided HIFU), measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL and the QLQ-BM22 questionnaires. MATERIALS AND METHODS: Twenty patients undergoing MR-guided HIFU in an international multicentre trial self-completed the QLQ-C15-PAL and QLQ-BM22 questionnaires before and on days 7, 14, 30, 60 and 90 post-treatment...
January 6, 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29317008/patients-with-advanced-cancer-and-depression-report-a-significantly-higher-symptom-burden-than-non-depressed-patients
#4
Kjersti Støen Grotmol, Hanne C Lie, Jon Håvard Loge, Nina Aass, Dagny Faksvåg Haugen, Patrick C Stone, Stein Kaasa, Marianne Jensen Hjermstad
OBJECTIVE: Clinical observations indicate that patients with advanced cancer and depression report higher symptom burden than nondepressed patients. This is rarely examined empirically. Study aim was to investigate the association between self-reported depression disorder (DD) and symptoms in patients with advanced cancer controlled for prognostic factors. METHOD: The sample included 935 patients, mean age 62, 52% males, from an international multicentre observational study (European Palliative Care Research Collaborative - Computerised Symptom Assessment and Classification of Pain, Depression and Physical Function)...
January 10, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29316883/active-ingredients-of-a-person-centred-intervention-for-people-on-hiv-treatment-analysis-of-mixed-methods-trial-data
#5
Keira Lowther, Richard Harding, Victoria Simms, Aabid Ahmed, Zipporah Ali, Nancy Gikaara, Lorraine Sherr, Hellen Kariuki, Irene J Higginson, Lucy Ellen Selman
BACKGROUND: A new model of care is required to meet the changing needs of people living with HIV (PLWH), particularly in low and middle-income countries, where prevalence is highest. We evaluated a palliative care intervention for PLWH in Mombasa, Kenya. Although we found no effect on pain (primary outcome), there was a positive effect on mental health (secondary outcome) in the intervention group. To inform replication and implementation, we have determined the active ingredients of the intervention and their mechanisms of action...
January 10, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29305321/factors-associated-with-symptom-relief-in-end-of-life-care-in-residential-care-homes-a-national-register-based-study
#6
Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström
BACKGROUND: Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. AIM: To explore the presence of symptoms and symptom relief, and identify factors associated with symptom relief of pain, nausea, anxiety, and shortness of breath among RCH residents in end-of-life care. METHOD: The data consisted of all expected deaths at RCHs registered in the Swedish Register of Palliative Care (n=22 855)...
January 2, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29297082/enhancing-recovery-from-sepsis-a-review
#7
REVIEW
Hallie C Prescott, Derek C Angus
Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29285946/implementation-of-a-metastatic-malignancy-of-unknown-primary-origin-service-led-by-a-palliative-physician
#8
David Brooks, Philippa Hughes, Clare Farrington, Peter A Bath, Mary McGregor, Wasim Ahmed, Bill Noble
BACKGROUND: Cancer of unknown primary is the fourth most common cause of cancer death in the United Kingdom. National guidance in 2010 recommended the establishment of a dedicated unknown primary team to facilitate targeted investigation and symptom control. A service development project was undertaken to identify those affected by malignancy of unknown origin and institute a pathway for coordinating their care led by a palliative physician. AIM: To describe the patient population and illness trajectory and to assess the effect of the new pathway on the clinical outcomes...
December 29, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29279492/cyberknife-stereotactic-radiosurgery-for-cholangiocarcinoma
#9
Yuko Harada, Shinichiro Miyazaki
Cholangiocarcinoma is a devastating cancer with a poor prognosis. Patients are often diagnosed at the advanced stage, and curative surgery is impossible. Radiation therapy is used for cases of advanced cancer. A 50-year-old woman with stage IVb intrahepatic cholangiocarcinoma was diagnosed with unresectable cancer, and had chemotherapy; however, the disease progressed. CyberKnife radiosurgery was performed, which was able to control the symptoms of liver failure and prolong her life. Her symptoms, which included jaundice, ascites, and edema disappeared and her tumor markers became normal...
December 27, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29249857/symptomatic-fluid-drainage-tunneled-peritoneal-and-pleural-catheters
#10
REVIEW
Tony Ha, David C Madoff, David Li
Malignant ascites and pleural effusion are significant contributors to patient symptoms such as shortness of breath, abdominal distension, and nausea in the setting of cancer. There are numerous methods employed to control such symptoms such as serial drainages, pleurodesis, and tunneled drainage catheters. Tunneled drainage catheters are a safe, effective, and a minimally invasive procedure to palliate the symptoms of malignant ascites and pleural effusion.
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29232340/ablative-therapies-for-locally-advanced-pancreatic-cancer
#11
Rupen Shah, Katherine T Ostapoff, Boris Kuvshinoff, Steven N Hochwald
The vast majority of patients who present with pancreatic adenocarcinoma have locally advanced or metastatic disease at the time of presentation without possibility of cure. Although in recent years there have been some new promising chemotherapy regimens that improve overall survival by a few months, the prognosis remains dismal. There is, however, a subset of patients who experience durable stable disease or partial responses after initial courses of chemotherapy with locally advanced disease. In these select patients, there remains interest in local ablative therapy with or without resection as a means for local control, palliation of symptoms, and possible improved survival...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29230124/oncology-and-palliative-medicine-providing-comprehensive-care-for-patients-with-cancer
#12
REVIEW
Laura Finn, Alva Roche Green, Sonia Malhotra
Background: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. Methods: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#13
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29221687/leptomeningeal-carcinomatosis-in-colorectal-cancer-the-mayo-clinic-experience
#14
Gretchen Taylor, Nina Karlin, Thorvardur R Halfdanarson, Kyle Coppola, Axel Grothey
BACKGROUND: Leptomeningeal metastasis (LM) is an uncommon form of metastatic disease in many cancers. There remains a paucity of literature with regard to the course and management of LM in colorectal cancers (CRCs). The aim of this study was to estimate the incidence of LM in patients with CRC seen at our institution over a 15-year period, and to describe the clinical course and outcome of these cases. METHODS: LM in CRC primary cases between 2000 and 2014 were identified in the Mayo Clinic databases...
November 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29196939/clinical-and-functional-implication-of-the-components-of-somatostatin-system-in-gastroenteropancreatic-neuroendocrine-tumors
#15
Aura D Herrera-Martínez, Manuel D Gahete, Sergio Pedraza-Arevalo, Rafael Sánchez-Sánchez, Rosa Ortega-Salas, Raquel Serrano-Blanch, Raúl M Luque, María A Gálvez-Moreno, Justo P Castaño
PURPOSE: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) comprise a heterogeneous group of malignancies often presenting with metastasis at diagnosis and whose clinical outcome is difficult to predict. Somatostatin (SST) analogs (SSAs) provide a valuable pharmacological tool to palliate hormonal symptoms, and control progression in some NETs. However, many patients do not respond to SSAs or develop resistance, and there are many uncertainties regarding pathophysiology of SST and its receptors (sst1-sst5) in GEP-NETs...
December 1, 2017: Endocrine
https://www.readbyqxmd.com/read/29190323/a-review-of-systemic-anticancer-therapy-in-disease-palliation
#16
C M Usborne, A P Mullard
Background: Systemic anticancer therapy (SACT) is a collective term to describe the growing number of differing therapies used in malignancy to achieve palliation. Improving symptoms, quality of life (QOL) and where possible quantity of life are the goals of these treatments. Sources of data: A comprehensive literature review was undertaken using Medline, Embase and the Cochrane database. Areas of agreement: The use of palliative SACT can lead to increases in symptom control, QOL and survival...
November 28, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29189093/a-palliative-radiation-oncology-consult-service-s-impact-on-care-of-advanced-cancer-patients
#17
Sanders Chang, Peter May, Nathan E Goldstein, Juan Wisnivesky, Kenneth Rosenzweig, R Sean Morrison, Kavita V Dharmarajan
INTRODUCTION: Palliative radiation therapy (PRT) is a commonly utilized intervention for symptom palliation among patients with metastatic cancer, yet it is under-recognized as a distinct area of subspecialty within radiation oncology. OBJECTIVE: We developed a multidisciplinary service model within radiation oncology called the Palliative Radiation Oncology Consult (PROC) service to improve the quality of cancer care for advanced cancer patients. We assessed the service's impact on patient-related and healthcare utilization outcomes...
November 30, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29187033/second-re-irradiation-a-narrative-review-of-the-available-clinical-data
#18
Carsten Nieder, Johannes A Langendijk, Matthias Guckenberger, Anca L Grosu
BACKGROUND: Considerable controversy exists about the safety and efficacy of second re-irradiations (three courses of radiotherapy to overlapping volumes). Therefore, all published clinical studies were reviewed. MATERIAL AND METHODS: Contemporary and historical articles were identified. Outcomes such as survival, local control, symptom improvement and side effects were extracted. Contemporary results were grouped by anatomical location of the re-irradiated region in the body...
November 30, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29165794/leptomeningeal-metastasis-from-systemic-cancer-review-and-update-on-management
#19
REVIEW
Nancy Wang, Mia S Bertalan, Priscilla K Brastianos
Leptomeningeal metastasis is an uncommon and typically late complication of cancer with a poor prognosis and limited treatment options. Diagnosis is often challenging, with nonspecific presenting symptoms ranging from headache and confusion to focal neurologic deficits, such as cranial nerve palsies. Standard diagnostic evaluation involves a neurologic examination, magnetic resonance imaging of the brain and spine with gadolinium, and cytologic evaluation of the cerebral spinal fluid. Therapy entails a multimodal approach focused on palliation with surgery, radiation, and/or chemotherapy, which may be administered systemically or directly into the cerebral spinal fluid...
November 22, 2017: Cancer
https://www.readbyqxmd.com/read/29164739/can-specially-trained-community-care-workers-effectively-support-patients-and-their-families-in-the-home-setting-at-the-end-of-life
#20
Roslyn G Poulos, Damian Harkin, Christopher J Poulos, Andrew Cole, Rod MacLeod
Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs)...
November 21, 2017: Health & Social Care in the Community
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