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Symptom control palliative

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https://www.readbyqxmd.com/read/28105900/feasibility-acceptability-and-tolerability-of-rgn107-in-the-palliative-wound-care-management-of-chronic-wound-symptoms
#1
M Madisetti, T J Kelechi, M Mueller, E J Amella, M A Prentice
OBJECTIVE: To assess the feasibility, acceptability and tolerability of RGN107 use, a natural powder blend of Arnica Montana, Calendula Officinalis, Mentha Arvensis and Santalum Album, among hospice patients and their wound caregivers in the palliative wound care management of chronic wound symptoms at end-of-life. METHOD: Data were collected between May 2013 and November 2015. A pilot trial conducted among 50 hospice patients with symptomatic (pain, odour, or exudate) chronic wounds...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28104470/a-cluster-randomized-trial-of-a-primary-palliative-care-intervention-connect-for-patients-with-advanced-cancer-protocol-and-key-design-considerations
#2
Claire L Becker, Robert M Arnold, Seo Young Park, Margaret Rosenzweig, Thomas J Smith, Douglas B White, Kenneth J Smith, Yael Schenker
BACKGROUND: The addition of specialty palliative care to standard oncology care improves outcomes for patients with advanced cancer and their caregivers, but many lack access to specialty care services. Primary palliative care-meaning basic palliative care services provided by clinicians who are not palliative care specialists-is an alternative approach that has not been rigorously evaluated. METHODS: A cluster randomized, controlled trial of the CONNECT (Care management by Oncology Nurses to address supportive care needs) intervention, an oncology nurse-led care management approach to providing primary palliative care for patients with advanced cancer and their family caregivers, is currently underway at 16 oncology practices in Western Pennsylvania...
January 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28097515/distress-is-interdependent-in-patients-and-caregivers-with-newly-diagnosed-incurable-cancers
#3
Jamie M Jacobs, Kelly M Shaffer, Ryan D Nipp, Joel N Fishbein, James MacDonald, Areej El-Jawahri, William F Pirl, Vicki A Jackson, Elyse R Park, Jennifer S Temel, Joseph A Greer
BACKGROUND: Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. PURPOSE: The aim of the study is to investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer. METHODS: From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or noncolorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care...
January 17, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/28078429/aims-and-tasks-in-parental-caregiving-for-children-receiving-palliative-care-at-home-a-qualitative-study
#4
Lisa M Verberne, Marijke C Kars, Antoinette Y N Schouten-van Meeteren, Diederik K Bosman, Derk A Colenbrander, Martha A Grootenhuis, Johannes J M van Delden
: In paediatric palliative care (PPC), parents are confronted with increasing caregiving demands. More children are cared for at home, and the need for PPC of children is lengthened due to technical and medical improvements. Therefore, a clear understanding of the content of parental caregiving in PPC becomes increasingly important. The objective is to gain insight into parental caregiving based on the lived experience of parents with a child with a life-limiting disease. An interpretative qualitative study using thematic analysis was performed...
January 11, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28065203/the-short-demoralization-scale-sds-a-new-tool-to-appraise-demoralization-in-palliative-care-patients
#5
Laura Galiana, David Rudilla, Amparo Oliver, Pilar Barreto
OBJECTIVE: The Demoralization Scale (DS) is the most widely used measure for assessing demoralization. Following the recent clamor for brief assessment tools, and taking into account that demoralization has proved to be a symptom that needs to be controlled and treated in the palliative care setting, a shorter scale is needed. The aim of the present research is to introduce and evaluate the Short Demoralization Scale (SDS). METHOD: We employed a cross-sectional design that included a survey of 226 Spanish palliative care patients from the Hospital General Universitario de Valencia...
January 9, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28053701/primary-thyroid-lymphoma-a-case-report-and-review-of-the-literature
#6
Rita Peixoto, João Correia Pinto, Virgínia Soares, Pedro Koch, António Taveira Gomes
INTRODUCTION: A rapidly enlarging mass of the anterior compartment of the neck with compressive symptoms may represent, among other diagnosis, a neoplasm of the thyroid gland. PRESENTATION OF CASE: We describe the case of a 59-year-old woman referred to the endocrine surgical unit because of compressive cervical symptoms for 3 months. The cervical ultrasound revealed a sub-sternal goiter with heterogeneous echo structure and the fine-needle aspirating cytology was inconclusive...
January 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28042066/repurposing-medications-for-hospice-palliative-care-symptom-control-is-no-longer-sufficient-a-manifesto-for-change
#7
David C Currow, Amy P Abernethy, Marie Fallon, Russell K Portenoy
The World Health Organisation (WHO) essential medications list for hospice / palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28041600/study-protocol-for-the-option-randomised-controlled-trial-on-the-effect-of-prioritising-treatment-goals-among-older-patients-with-cancer-in-a-palliative-setting
#8
M E Stegmann, J Schuling, T J N Hiltermann, A K L Reyners, H Burger, M Y Berger, A J Berendsen
PURPOSE: Traditionally, general practitioners (GPs) are not involved in cancer-related treatment decisions, despite their often long relationship with patients, and their unique position to explore patients' values, especially with older patients. Therefore, we designed a randomised controlled trial to study the effect, on self-efficacy related to treatment decisions, of a conversation about treatment goals between GPs and patients with cancer in a palliative setting. METHODS: We aim to include 168 patients aged ≥70 years with a diagnosis of non-curable cancer, due to consult their oncologist about treatment options...
February 2017: Maturitas
https://www.readbyqxmd.com/read/28008570/the-role-of-interventional-radiology-in-the-treatment-of-intrahepatic-cholangiocarcinoma
#9
Anna Maria Ierardi, Salvatore Alessio Angileri, Francesca Patella, Silvia Panella, Natalie Lucchina, Elena N Petre, Antonio Pinto, Giuseppe Franceschelli, Gianpaolo Carrafiello, Gianpaolo Cornalba, Constantinos T Sofocleous
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma. Complete surgical resection remains the only potentially curative option for patients with ICC. However, until now, early diagnosis with potential surgical intervention has been the exception rather than the rule with only 30% of patients qualifying for attempted surgical cure. Many patients are unresectable because of disease stage, anatomic conditions, medical comorbidities, and small future remnant liver...
January 2017: Medical Oncology
https://www.readbyqxmd.com/read/27997005/-urgent-hospitalization-of-the-cancer-patient-problems-and-opportunity
#10
Gianmauro Numico, Maura Rossi
Cancer patients are frequently subject to non programmed access to the emergency department or to the oncological services. The main underlying needs are disease-related symptoms, treatment-related toxicity and end-of-life issues. Sudden events frequently change the trajectory of the disease and ask for rapid changes of cancer care. Hospital admission is frequently an unavoidable step in clinical history, especially in the last months of life. While an improvement in symptoms management and a tighter patients' control could prevent from the unexpected worsening of clinical conditions, oncologists and emergency physicians are called to a strict cooperation...
December 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27992502/what-is-the-value-of-surgical-intervention-for-sacral-metastases
#11
Zhiye Du, Wei Guo, Rongli Yang, Xiaodong Tang, Tao Ji, Dasen Li
OBJECTIVE: To investigate the impact of surgery on local control and quality of life for patients with sacral metastases and to determine whether the complications of surgery were acceptable. METHODS: Curettage for metastatic lesions of the sacrum was performed in 154 patients with obvious sacral nerve compression symptoms between July 1997 and July 2014. Potential risk factors were evaluated in univariate analysis for associations with local control; multivariate conditional logistic regression was used to identify the combined effects...
2016: PloS One
https://www.readbyqxmd.com/read/27984330/palliative-care-in-pulmonary-arterial-hypertension
#12
Wendy Gin-Sing
PURPOSE OF REVIEW: Developments in the management of pulmonary arterial hypertension have significantly improved prognosis changing this from an acute to a chronic disease. Despite optimal treatment many patients still have a high-symptom burden both because of the disease and the side-effects of therapy, consequently there is an increasing need for a palliative care approach to improve the quality of life for this patient group. This review article will outline the need for palliative care support for patients with pulmonary arterial hypertension, discuss the barriers that currently exist and suggest how this may be improved...
December 15, 2016: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/27940628/what-determines-duration-of-palliative-care-before-death-for-patients-with-advanced-disease-a-retrospective-cohort-study-of-community-and-hospital-palliative-care-provision-in-a-large-uk-city
#13
Michael I Bennett, Lucy Ziegler, Matthew Allsop, Sunitha Daniel, Adam Hurlow
OBJECTIVE: For patients with advanced cancer, several randomised controlled trials have shown that access to palliative care at least 6 months before death can improve symptoms, reduce unplanned hospital admissions, minimise aggressive cancer treatments and enable patients to make choices about their end-of-life care, including exercising the choice to die at home. This study determines in a UK population the duration of palliative care before death and explores influencing factors...
December 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932629/breathlessness-during-daily-activity-the-psychometric-properties-of-the-london-chest-activity-of-daily-living-scale-in-patients-with-advanced-disease-and-refractory-breathlessness
#14
Charles C Reilly, Claudia Bausewein, Rachel Garrod, Caroline J Jolley, John Moxham, Irene J Higginson
BACKGROUND: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. AIM: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. DESIGN: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034)...
December 8, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27928789/-surgical-management-of-locally-advanced-digestive-tract-neuroendocrine-neoplasm-with-or-without-liver-metastasis
#15
Xiaosong Wang, Jiangfeng Qiu, Zhiyong Wu
Neuroendocrine tumors in the digestive tract are rare, however their incidences increased obviously for the past few years. The purpose of this paper is to elucidate the surgical management of locally advanced digestive tract neuroendocrine neoplasms(NENs) with or without liver metastasis and to discuss the present classification of gastrointestinal NENs in order to provide reference for clinicians. WHO re-classified the gastroenteropancreatic NENs in 2010, but this classification remains many questions and needs further clinical trials to answer...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#16
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27903668/malignant-pleural-mesothelioma-an-update-on-investigation-diagnosis-and-treatment
#17
Anna C Bibby, Selina Tsim, Nikolaos Kanellakis, Hannah Ball, Denis C Talbot, Kevin G Blyth, Nick A Maskell, Ioannis Psallidas
Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27899400/study-protocol-a-phase-iii-randomised-double-blind-parallel-arm-stratified-block-randomised-placebo-controlled-trial-investigating-the-clinical-effect-and-cost-effectiveness-of-sertraline-for-the-palliative-relief-of-breathlessness-in-people-with-chronic-breathlessness
#18
Gareth J Watts, Katherine Clark, Meera Agar, Patricia M Davidson, Christine McDonald, Lawrence T Lam, Dimitar Sajkov, Nicola McCaffrey, Matthew Doogue, Amy P Abernethy, David C Currow
INTRODUCTION: Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness...
November 29, 2016: BMJ Open
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#19
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893131/association-between-palliative-care-and-patient-and-caregiver-outcomes-a-systematic-review-and-meta-analysis
#20
REVIEW
Dio Kavalieratos, Jennifer Corbelli, Di Zhang, J Nicholas Dionne-Odom, Natalie C Ernecoff, Janel Hanmer, Zachariah P Hoydich, Dara Z Ikejiani, Michele Klein-Fedyshin, Camilla Zimmermann, Sally C Morton, Robert M Arnold, Lucas Heller, Yael Schenker
Importance: The use of palliative care programs and the number of trials assessing their effectiveness have increased. Objective: To determine the association of palliative care with quality of life (QOL), symptom burden, survival, and other outcomes for people with life-limiting illness and for their caregivers. Data Sources: MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL to July 2016. Study Selection: Randomized clinical trials of palliative care interventions in adults with life-limiting illness...
November 22, 2016: JAMA: the Journal of the American Medical Association
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