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https://www.readbyqxmd.com/read/28720558/my-team-of-care-study-a-pilot-randomized-controlled-trial-of-a-web-based-communication-tool-for-collaborative-care-in-patients-with-advanced-cancer
#1
Teja Voruganti, Eva Grunfeld, Trevor Jamieson, Allison M Kurahashi, Bhadra Lokuge, Monika K Krzyzanowska, Muhammad Mamdani, Rahim Moineddin, Amna Husain
BACKGROUND: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management...
July 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28718321/breathlessness-services-as-a-new-model-of-support-for-patients-with-respiratory-disease
#2
Claudia Bausewein, Michaela Schunk, Philipp Schumacher, Julika Dittmer, Anna Bolzani, Sara Booth
The complexity of breathlessness in advanced disease requires a diversity of measures ideally tailored to the individual patient needs. 'Breathlessness services' have been systematically developed and tested to provide specific interventions and support for patients and their carers. The aim of this article is (1) to identify and describe components of breathlessness services and (2) to describe the clinical model of one specific service in more detail. This article is based on a systematic review evaluating randomized controlled trials (RCTs) and quasi-RCTs which examine the effectiveness of services aiming to improve breathlessness of patients with advanced disease...
January 1, 2017: Chronic Respiratory Disease
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
#3
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/28711751/the-conversion-ratio-from-intravenous-hydromorphone-to-oral-opioids-in-cancer-patients
#4
Akhila Reddy, Marieberta Vidal, Saneese Stephen, Karen Baumgartner, Sara Dost, Ann Nguyen, Yvonne Heung, Simeon Kwan, Angelique Wong, Imelda Pangemanan, Ahsan Azhar, Supakarn Tayjasanant, Edenmae Rodriguez, Jessica Waletich, Kyu-Hyoung Lim, Jimin Wu, Diane Liu, Janet Williams, Sriram Yennurajalingam, Eduardo Bruera
BACKGROUND: The lack of knowledge of the accurate conversion ratio (CR) between intravenous (IV) and oral hydromorphone and opioid rotation ratio (ORR) between IV hydromorphone and oral morphine equivalent daily dose (MEDD) may lead to poorly controlled pain or overdosing in cancer inpatients. We aimed to determine the CR and ORR from IV hydromorphone to oral hydromorphone and MEDD (obtained from oral morphine and oxycodone). METHODS: 4745 consecutive inpatient palliative care consults during 2010-14 were reviewed for conversions from IV hydromorphone to oral hydromorphone, morphine or oxycodone...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28708236/psychosocial-interventions-for-fatigue-during-cancer-treatment-with-palliative-intent
#5
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/28708043/reirradiation-spine-stereotactic-body-radiation-therapy-for-spinal-metastases-systematic-review
#6
Sten Myrehaug, Arjun Sahgal, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben Slotman, Antonio De Salles
OBJECTIVE Spinal metastases that recur after conventional palliative radiotherapy have historically been difficult to manage due to concerns of spinal cord toxicity in the retreatment setting. Spine stereotactic body radiation therapy (SBRT), also known as stereotactic radiosurgery, is emerging as an effective and safe means of delivering ablative doses to these recurrent tumors. The authors performed a systematic review of the literature to determine the clinical efficacy and safety of spine SBRT specific to previously irradiated spinal metastases...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28707846/palliative-sedation-ethical-aspects
#7
Guido Miccinesi, Augusto Caraceni, Marco Maltoni
Palliative sedation (PS), the medical act of decreasing a patient's awareness to relieve otherwise intractable suffering, is considered by some commentators to be controversial because of its consequences on residual survival and/or quality of life, and to be inappropriate for treating pure existential suffering. We will argue that PS must be always proportional, i.e. controlling refractory symptoms while keeping the loss of personal values (communication, affective relationships, care relationship) as low as possible, and that imminence of death is necessary too, from an ethical point of view, if a deep and continuous sedation (DCS) is proposed...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28707168/acupuncture-for-cancer-related-fatigue-in-lung-cancer-patients-a-randomized-double-blind-placebo-controlled-pilot-trial
#8
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/28697317/management-of-malignant-bowel-obstruction-associated-with-gi-cancers
#9
Aaron J Franke, Atif Iqbal, Jason S Starr, Rajesh M Nair, Thomas J George
For many patients with GI malignancies, the seeding of the abdominal cavity with tumor cells, called peritoneal carcinomatosis, is a common mode of metastases and disease progression. Prognosis for patients with this aspect of their disease remains poor, with high disease-related morbidity and complications. Uniform and proven practices that provide optimal palliative care and quality of life for these patients are needed. The objective of this review is to critically assess the current literature regarding palliative strategies in the management of peritoneal carcinomatosis and associated symptoms in patients with advanced GI cancers...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#10
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28682882/breast-liposarcoma-with-solitary-metastasis-to-the-pleura-a-case-report
#11
Lei Lei, Zhanhong Chen, Zhuo Wang, Linfeng Zheng, Yabing Zheng, Xiaojia Wang, Xian Wang
RATIONALE: Breast cancer is the most prevalent malignancy in women worldwide. Our patient presented with a history of breast liposarcoma (LPS) and was found to have pleural metastasis during the initial workup. PATIENT CONCERNS: The patient was complaining about chest pain and dyspnea that had persisted for a week. DIAGNOSES: After a full evaluation and histological diagnosis, she was diagnosed as metastatic breast LPS. INTERVENTIONS: We adopted 6 cycles of pegylated liposomal doxorubicin (PLD) plus ifosfamide as 1st-line palliative chemotherapy, combined with local pleural effusion management...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28682818/respiratory-problems-in-low-resource-settings
#12
Mhoira E F Leng, Sunitha Daniel, Daniel Munday
PURPOSE OF REVIEW: Chronic breathlessness is common in patients with advanced illness who require palliative care. Achieving good symptom control can be challenging. More people with advanced illness live in low and middle income than in high-income countries, but they are much less likely to receive palliative care. Most of the emerging evidence for the palliative management of chronic breathlessness is from high-income countries. This review explores the context of chronic breathlessness in low-income settings, how evidence for control of chronic breathlessness might relate to these settings and where further work should be focused...
July 5, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28671265/corticosteroids-for-adult-patients-with-advanced-cancer-who-have-nausea-and-vomiting-not-related-to-chemotherapy-radiotherapy-or-surgery
#13
REVIEW
Petra Vayne-Bossert, Alison Haywood, Phillip Good, Sohil Khan, Kirsty Rickett, Janet R Hardy
BACKGROUND: Nausea is a common symptom in advanced cancer, with a prevalence of up to 70%. While nausea and vomiting can be related to cancer treatments, such as chemotherapy, radiotherapy, or surgery, a significant number of people with advanced cancer also suffer from nausea unrelated to such therapies. Nausea and vomiting may also cause psychological distress, and have a negative impact on the quality of life of cancer patients; similarly to pain, nausea is often under-treated. The exact mechanism of action of corticosteroids on nausea is unclear, however, they are used to manage a number of cancer-specific complications, including spinal cord compression, raised intracranial pressure, and lymphangitis carcinomatosis...
July 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28667207/a-cluster-randomised-controlled-proof-of-concept-study-to-explore-the-feasibility-and-effect-of-a-patient-directed-intervention-on-quality-of-life-in-patients-with-advanced-soft-tissue-sarcoma
#14
Markus Schuler, Stephan Richter, Gerhard Ehninger, Martin Bornhäuser, Leopold Hentschel
INTRODUCTION: Even with evolving and expanding therapeutical options for the treatment of advanced sarcomas over recent years, the balance between efficacy and toxicity still remains a major concern. Moreover, the symptom burden in patients with sarcoma remains high compared with other malignant diseases. It is, therefore, crucial to assess treatment effectiveness not only in terms of disease-related outcomes (eg, overall survival) but also from an individual and patient-centred perspective using the assessment of patient-reported outcomes (PROs)...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28662992/candidate-gene-investigation-of-spinal-degenerative-osteoarthritis-in-greek-population
#15
E Liva, I Panagiotou, S Palikyras, E Parpa, E Tsilika, P Paschou, K Mystakidou
BACKGROUND CONTEXT: Few data exist concerning the natural history of degenerative osteoarthritis of the spine and its associated gene investigation. Degenerative osteoarthritis of the spine demonstrates an international prevalence of 15% in the general population and over 50% in people aged over 60 years. PURPOSE: The aim of this Greek case-control study is to examine gene polymorphisms that have been previously shown or hypothesized to be correlated to degenerative osteoarthritis of the spine...
June 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28661900/palliative-care-and-interstitial-lung-disease
#16
Sabrina Bajwah, Janelle Yorke
PURPOSE OF REVIEW: The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to improve symptom control and quality of life and where possible this should be evidence based. RECENT FINDINGS: Deaths from ILD are increasing and deaths in hospital are more common compared to home. People with ILD experience a wide range of symptoms including breathlessness and cough...
June 28, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28659006/training-hospital-staff-on-spiritual-care-in-palliative-care-influences-patient-reported-outcomes-results-of-a-quasi-experimental-study
#17
Joep van de Geer, Marieke Groot, Richtsje Andela, Carlo Leget, Jelle Prins, Kris Vissers, Hetty Zock
BACKGROUND: Spiritual care is reported to be important to palliative patients. There is an increasing need for education in spiritual care. AIM: To measure the effects of a specific spiritual care training on patients' reports of their perceived care and treatment. DESIGN: A pragmatic controlled trial conducted between February 2014 and March 2015. SETTING/PARTICIPANTS: The intervention was a specific spiritual care training implemented by healthcare chaplains to eight multidisciplinary teams in six hospitals on regular wards in which patients resided in both curative and palliative trajectories...
November 1, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/28651827/effects-of-nutrition-and-physical-exercise-intervention-in-palliative-cancer-patients-a-randomized-controlled-trial
#18
Alexandra Uster, Maya Ruehlin, Stefanie Mey, David Gisi, Ruud Knols, Reinhard Imoberdorf, Miklos Pless, Peter E Ballmer
BACKGROUND & AIMS: Cancer cachexia is multifactorial and should be targeted using a multimodal form of intervention. The purpose of the present trial was to test the effects of a combined nutrition and physical exercise program on cancer patients with metastatic or locally advanced tumors of the gastrointestinal and lung tracts. METHODS: Patients were randomized into two groups: One group received a minimum of three standardized individual nutritional counselling sessions and participated in a 60-min exercise program twice a week...
June 8, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28646590/randomized-controlled-double-blind-trial-comparing-haloperidol-combined-with-conventional-therapy-to-conventional-therapy-alone-in-patients-with-symptomatic-gastroparesis
#19
Carlos J Roldan, Kimberly A Chambers, Linda Paniagua, Sonali Patel, Marylou Cardenas-Turanzas, Yashwant Chathampally
OBJECTIVE: Gastroparesis is a debilitating condition that causes nausea, vomiting, and abdominal pain. Management includes analgesics and antiemetics, but symptoms are often refractory. Haloperidol has been utilized in the palliative care setting for similar symptoms. The study objective was to determine whether haloperidol as an adjunct to conventional therapy would improve symptoms in gastroparesis patients presenting to the emergency department. METHODS AND TRIAL DESIGN: This was a randomized, double-blind, placebo-controlled trial of adult emergency department patients with acute exacerbation of previously diagnosed gastroparesis...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28644748/paediatric-palliative-medicine-2nd-ed
#20
Roger Woodruff
Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
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