0000000000024479

AUTHOR

Alessandro Valle

showing 13 related works from this author

Emergencies in patients with advanced cancer followed at home.

2012

Abstract CONTEXT: Patients with advanced cancer stay at home for most of their time, and acute problems may occur during home care. Caregivers may call medical services for an emergency, which can result in patients being admitted to the hospital. No data exist on emergencies in patients followed by a home care team. OBJECTIVES: The aim of this multicenter prospective study was to assess the frequency, reasons for, and subsequent course of emergency calls for patients followed at home by a palliative care team. METHODS: A consecutive sample of patients admitted to home care programs was surveyed for a period of seven months. Epidemiological data, and characteristics of emergency calls and o…

Malemedicine.medical_specialtyEmergency Medical ServicesPalliative careMEDLINEContext (language use)Settore MED/42 - Igiene Generale E Applicataadvanced cancer; home care; epidemiologic studypalliative care emergencyNeoplasmsEpidemiologymedicineEmergency medical servicesadvanced cancerHumansIn patientProspective StudiesKarnofsky Performance StatusProspective cohort studyNursing (all)2901 Nursing (miscellaneous)General NursingAgedpalliative carebusiness.industryemergency medical caremedicine.diseaseHome Care ServicesTelephoneAnesthesiology and Pain Medicineemergency medical care; Home care; palliative care; palliative care emergency; Aged; Caregivers; Emergency Medical Services; Female; Home Care Services; Humans; Italy; Karnofsky Performance Status; Male; Neoplasms; Prospective Studies; Telephone; Emergencies; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)CaregiversItalyepidemiologic studyEmergency medicineDeliriumFemaleNeurology (clinical)Medical emergencymedicine.symptomEmergencieshome carebusinessJournal of pain and symptom management
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Relationship between background cancer pain, breakthrough pain, and analgesic treatment: a preliminary study for a better interpretation of epidemiol…

2020

Abstract Abstract Background: The different operational definitions of breakthrough cancer pain (BTcP) has generated unclear epidemiological data. Methods: A consecutive sample of patients was categorized on the basis of their background pain intensity, background analgesic treatment, and the presence of BTcP. Results: A total of 265 patients were surveyed; 117 patients had background pain and 91 patients presented peaks of pain intensity distinguishable from background pain. Of 117 patients with background pain, 49 patients were re-assessed after optimization of background analgesia (T1) within a mean of 8.2 days. Pain intensity significantly decreased in comparison with values recorded at…

Malemedicine.medical_specialtyEpidemiologyBreakthrough PainAnalgesicOpioidSettore MED/42 - Igiene Generale E ApplicataCONSECUTIVE SAMPLENeoplasmsSurveys and QuestionnairesEpidemiologyMedicineHumansPain ManagementCancer painPain MeasurementAnalgesicsbackground cancer painbusiness.industryMedicine (all)General MedicineBreakthrough pain; Cancer pain; Epidemiology; Opioids; Analgesics Opioid; Breakthrough Pain; Female; Humans; Male; Neoplasms; Pain Management; Pain Measurement; Surveys and Questionnaires; Medicine (all)breakthrough painIntensity (physics)OpioidsAnalgesics OpioidAnesthesiaepidemiologic studyFemaleCancer painbusinessbackground cancer pain; breakthrough pain; epidemiologic study
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Palliative sedation in advanced cancer patients followed at home: A retrospective analysis

2012

Abstract CONTEXT: Data regarding palliative sedation at home in dying patients are lacking. OBJECTIVES: To describe the frequency, indication, and modality of palliative sedation (PS) in patients followed at home. METHODS: A retrospective analysis of home care cancer patients was performed. Patients who received PS before dying were selected and information about epidemiologic characteristics, indications, duration, drugs, and outcomes was collected. RESULTS: Of 370 medical charts of patients who died at home, 49 patients received PS before dying. PS was proposed by the team, relatives, or both in 63.3%, 4.1%, and 32.6% of cases, respectively. Delirium alone or in combination with other sym…

end of lifeMalePediatricsmedicine.medical_specialtyPalliative carePainComorbiditySettore MED/42 - Igiene Generale E ApplicataPalliative sedationadvanced cancer patientPalliative sedationRisk FactorsNeoplasmsRETROSPECTIVE STUDYPrevalenceMedicineHumansHypnotics and SedativesPALLIATIVE SEDATION; advanced cancer patients; RETROSPECTIVE STUDYIntensive care medicineSurvival rateGeneral NursingSurvival analysisNursing (all)2901 Nursing (miscellaneous)Retrospective StudiesTerminal Carepalliative carebusiness.industryDeliriumRetrospective cohort studymedicine.diseaseComorbidityHome Care ServicesSurvival AnalysisSurvival RateTreatment OutcomeAnesthesiology and Pain MedicineItalyend of life; home care; palliative care; Palliative sedation; Comorbidity; Delirium; Female; Home Care Services; Humans; Hypnotics and Sedatives; Italy; Male; Neoplasms; Pain; Palliative Care; Prevalence; Retrospective Studies; Risk Factors; Survival Analysis; Survival Rate; Terminal Care; Treatment Outcome; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)MidazolamDeliriumFemaleNeurology (clinical)medicine.symptombusinesshome caremedicine.drug
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Opioid switching in patients with advanced cancer followed at home. A retrospective analysis.

2013

Abstract CONTEXT: Opioid switching has been found to improve opioid responsiveness in different conditions. However, data on opioid switching performed at home are almost nonexistent, despite the fact that most patients are followed at home. OBJECTIVES: The aim of this retrospective survey was to determine frequency, indications, usefulness, and safety of opioid switching when treating advanced cancer-related pain in patients followed at home. METHODS: A retrospective review of data from patients with advanced cancer followed at home by three home care teams for a period of two years was performed. Patients who had their opioids switched were selected. Reasons for switching opioid doses and…

Maleretrospective studyComorbiditySettore MED/42 - Igiene Generale E Applicataadvanced cancer patientNeoplasmsRetrospective analysisPrevalenceOpioid switching; advanced cancer patients; retrospective studyCancer painProspective cohort studyNursing (all)2901 Nursing (miscellaneous)General NursingAnalgesicsDrug SubstitutionHome Care ServicesAnalgesics OpioidCausalitySurvival RateTreatment OutcomeItalyFemaleDrugmedicine.drugmedicine.medical_specialtyAnalgesicPainContext (language use)OpioidDose-Response RelationshipmedicineHumansIn patientIntensive care medicineAgedRetrospective StudiesDose-Response Relationship Drugbusiness.industryAdvanced cancerSurvival AnalysisCancer pain; home care; opioid switching; Aged; Analgesics Opioid; Causality; Comorbidity; Dose-Response Relationship Drug; Drug Substitution; Female; Home Care Services; Humans; Italy; Male; Neoplasms; Pain; Prevalence; Quality of Life; Retrospective Studies; Survival Analysis; Survival Rate; Treatment Outcome; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)Anesthesiology and Pain MedicineOpioidEmergency medicineMorphineOpioid switchingQuality of LifeNeurology (clinical)home carebusinessJournal of pain and symptom management
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Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study

2014

Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4).…

AdultMaleend of lifemedicine.medical_specialtyPalliative careContext (language use)Settore MED/42 - Igiene Generale E ApplicataPalliative sedationend of life; midazolam; palliative care; Palliative sedation; Adult; Aged; Aged 80 and over; Delirium; Dyspnea; Family; Feasibility Studies; Female; Humans; Hypnotics and Sedatives; Italy; Male; Midazolam; Middle Aged; Neoplasms; Palliative Care; Patient Care Team; Prospective Studies; Terminal Care; Young Adult; Home Care Services; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous); Medicine (all)Young AdultPalliative sedationNeoplasms80 and overmedicineHumansHypnotics and SedativesFamilyIn patientProspective StudiesIntensive care medicineProspective cohort studyNursing (all)2901 Nursing (miscellaneous)General NursingAgedAged 80 and overPatient Care TeamTerminal Carepalliative carebusiness.industryMedicine (all)DeliriumMiddle AgedHome Care ServicesAdvanced cancerDistressDyspneaAnesthesiology and Pain MedicinePalliative sedation; end of life; midazolam; palliative careItalymidazolamEmergency medicineFeasibility StudiesMidazolamFemaleNeurology (clinical)businessmedicine.drugJournal of Pain and Symptom Management
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Factors involved in gastrointestinal bleeding in advanced cancer patients followed at home

2003

Abstract There is a lack of information on the frequency of symptomatic gastrointestinal bleeding in patients with advanced cancer. This group of patients presents several risk factors for developing gastrointestinal bleeding. The aim of this multicenter longitudinal survey was to assess the frequency of gastrointestinal bleeding and possible factors implicated in advanced cancer patients followed at home. A consecutive sample of 439 patients who referred to home palliative care program entered the study. Age, gender, primary cancer and known metastases, possible associated pathologies, history of peptic disease, use of previous or actual nonsteroidal anti-inflammatory drugs (NSAIDs) and st…

Malemedicine.medical_specialtyGastrointestinal bleedingPalliative careBlood transfusionAnemiamedicine.medical_treatmentgastrointestinal bleedingSettore MED/42 - Igiene Generale E ApplicataGastroenterologyadvanced cancer patientGastrointestinal AgentsRisk FactorsMelenaNeoplasmsInternal medicinemedicineHumansLongitudinal StudiesProspective StudiesProspective cohort studybusiness.industryAnti-Inflammatory Agents Non-SteroidalPalliative CareCancermedicine.diseaseHome Care ServicesAdvanced cancerhome palliative careOncologyFemaleSteroidsmedicine.symptomGastrointestinal HemorrhagebusinessFollow-Up StudiesSupportive Care in Cancer
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Sleep Disturbances in Patients with Advanced Cancer in Different Palliative Care Settings.

2015

Abstract Context Information regarding sleep disturbances in the population with advanced cancer is meager. Objectives To assess the prevalence of sleep disturbances and possible correlations with associated factors in a large number of patients with advanced cancer admitted to different palliative care settings. Methods This was an observational study performed in different settings of palliative care. A consecutive sample of patients with advanced cancer was prospectively assessed for a period of six months. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System scores, and concomitant medical treatment were recorded.…

medicine.medical_specialtyPediatricsPalliative careCross-sectional studyinsomniaPopulationSleep disturbanceadvanced cancer; insomnia; palliative care; Sleep disturbances; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)Sleep Wake DisordersHospital Anxiety and Depression ScalemedicineInsomniaadvanced cancerAthens insomnia scaleeducationProspective cohort studyGeneral NursingNursing (all)2901 Nursing (miscellaneous)education.field_of_studypalliative carebusiness.industrySleep disturbancesAnesthesiology and Pain MedicinePhysical therapyNeurology (clinical)medicine.symptombusiness
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Pattern and characteristics of advanced cancer patients admitted to hospices in Italy

2013

Abstract The aim of this multicenter study was to assess the pattern and the characteristics of advanced cancer patients admitted to hospices. A consecutive sample of patients admitted in a period of 6 months was taken into consideration. Two hundred thirty-six patients admitted to hospices were consecutively assessed. Ninety-six percent of patients were admitted in acute hospital in the previous 3 months, with a mean time spent in hospital of 34.5 days, and 47 % of patients had received chemotherapy the month before hospice admission. Thirty-four percent of patients for whom data were available had significant persistent pain, and 44 % of them presented episodes of breakthrough pain. Sixty…

AdultMalemedicine.medical_specialtyPalliative caredescriptive studyPain medicineSettore MED/42 - Igiene Generale E ApplicataFentanyladvanced cancer patientNeoplasmsOutcome Assessment Health CaremedicineHumansProspective StudiesIntensive care medicineProspective cohort studySurvival analysisAgedadvanced cancer patients; hospice; descriptive studyAged 80 and overTerminal CareMarital Statusbusiness.industryNursing researchPalliative CareHospicesLength of StayMiddle AgedSurvival AnalysisAnalgesics OpioidLogistic ModelsOncologyOpioidItalyhospiceEmergency medicineMarital statusFemalebusinessmedicine.drug
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Long-term efficacy and tolerability of intranasal fentanyl in the treatment of breakthrough cancer pain

2015

Purpose: The aim of the present study was to assess the long-term tolerability and efficacy of intranasal fentanyl (INFS) in opioid-tolerant patients with breakthrough cancer pain (BTP).Patients and methods: A 6 months, observational, prospective, cohort study design was employed to follow advanced cancer patients with BTP receiving INFS under routine clinical practice. Eligible adult cancer patients suffering from BTP had been prescribed INFS at effective doses. Data were collected at T0 and at month intervals for six months. The principal outcomes were the evaluation of possible serious adverse effects with prolonged use of INFS, the efficacy of BTP treatment with INFS, the quality of sle…

AdultMalemedicine.medical_specialtySettore MED/42 - Igiene Generale E ApplicataFentanylCohort StudiesPatient satisfactionNeoplasmsInternal medicineparasitic diseasesHumansPain ManagementMedicineProspective StudiesCancer painAdverse effectProspective cohort studyAdministration IntranasalAgedPain Measurementbusiness.industryBreakthrough PainMiddle AgedTolerabilityDiscontinuationAnalgesics OpioidFentanylBreakthrough pain; Cancer pain; Intranasal fentanyl; Tolerability; OncologyOncologyTolerabilityPatient SatisfactionAnesthesiaIntranasal fentanylFemaleSleepbusinessCancer painmedicine.drugCohort studySupportive Care in Cancer
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Palliative sedation in patients with advanced cancer followed at home: A systematic review

2011

Abstract Context Patients with advanced cancer who are near the end of life may experience intolerable suffering refractory to targeted palliative therapies. Palliative sedation (PS) is considered to be an effective treatment modality for these refractory symptoms when aggressive efforts fail to provide relief. Objectives The aim of this study was to systematically review articles regarding PS performed at home in patients with intractable symptoms. Methods Literature databases searched included MedLine, PubMed, and EMBASE. The text words and MeSH/EMTREE terms "home care" and "sedation" were used for electronic database searches. Results Six articles met the inclusion criteria for research …

end of lifemedicine.medical_specialtyPalliative careSedationMEDLINEPainContext (language use)Palliative sedationend of life; home care; Palliative sedation; Clinical Trials as Topic; Delirium; Dyspnea; Home Care Services; Humans; Hypnotics and Sedatives; Neoplasms; Pain; Retrospective Studies; Treatment Outcome; Palliative Care; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)NeoplasmsmedicineHumansHypnotics and SedativesIntensive care medicineProspective cohort studyGeneral NursingNursing (all)2901 Nursing (miscellaneous)Retrospective StudiesClinical Trials as Topicbusiness.industryPalliative CareDeliriumRetrospective cohort studyHome Care ServicesDyspneaTreatment OutcomeAnesthesiology and Pain MedicineMeta-analysisMidazolamNeurology (clinical)medicine.symptombusinesshome caremedicine.drug
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Prognostic factors of survival in patients with advanced cancer admitted to home care

2011

Abstract CONTEXT: Data regarding prognostication of life expectancy in patients with advanced cancer are of paramount importance to patients, families, and clinicians. However, data regarding patients followed at home are lacking. OBJECTIVES: The aim of this study was to evaluate the correlation between various factors recorded at the beginning of home care assistance and survival. METHODS: A sample of consecutive patients admitted to two home care programs was surveyed. A preliminary consensus was achieved as to the possible variables easy to be recorded at home. These included age at the time of home care admission, gender, residence, marital status, primary cancer diagnosis, Karnofsky Pe…

Malemedicine.medical_specialtyPalliative careMEDLINEContext (language use)advanced cancer; Home care; prognosis; survival; Age Factors; Aged; Aged 80 and over; Dyspnea; Fatigue; Female; Humans; Male; Middle Aged; Neoplasms; Palliative Care; Prognosis; Quality of Life; Sex Factors; Survival Rate; Home Care Services; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)Prognostic survival factorSettore MED/42 - Igiene Generale E ApplicatasurvivalHome careadvanced cancer patientSex FactorsQuality of lifeNeoplasms80 and overadvanced cancerHumansMedicineSurvival rateFatigueNursing (all)2901 Nursing (miscellaneous)General NursingAgedAged 80 and overbusiness.industryPalliative CareAge FactorsPrognostic survival factors; advanced cancer patients; home careMiddle AgedPrognosisHome Care ServicesSurvival RateDyspneaAnesthesiology and Pain MedicineBlood pressureEmergency medicineQuality of LifeLife expectancyPhysical therapyMarital statusFemaleNeurology (clinical)business
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Orphan symptoms in advanced cancer patients followed at home

2013

Abstract Orphan symptoms are rarely assessed, particularly at home. The aim of this multicenter prospective study was to assess the prevalence of these symptoms and eventual factors possibly associated in advanced cancer patients at admission of a home care program. A prospective study was performed at three home care programs in Italy. Patients' data were collected, including age, sex, diagnosis, and Karnofsky status. Possible contributing factors were analyzed; preexisting neurological diseases, cerebral metastases, hyperthermia, diabetes, a state of dehydration clinically evident and/or oliguria, possible biochemical parameters when available, data regarding recent chemotherapy, opioids …

MyoclonusMalemedicine.medical_specialtyPalliative careHiccup; Home care; Myoclonus; Palliative care; Pruritus; Sweating; Tenesmus; Aged; Analgesics Opioid; Female; Fentanyl; Hiccup; Home Care Services; Hospitalization; Humans; Italy; Karnofsky Performance Status; Male; Myoclonus; Neoplasms; Prospective Studies; Pruritus; Sweating; Oncology; Medicine (all)Hiccup; Home care; Myoclonus; Palliative care; Pruritus; Sweating; TenesmusSweatingOpioidSettore MED/42 - Igiene Generale E ApplicataHome careFentanylHiccupPrurituOliguriaInternal medicineDiabetes mellitusNeoplasmsMedicineHumansVesical tenesmusProspective StudiesKarnofsky Performance StatusProspective cohort studyAgedAnalgesicsbusiness.industryPruritusMedicine (all)Tenesmusmedicine.diseaseHome Care ServicesAnalgesics OpioidFentanylHospitalizationDistressItalyOncologyAnesthesiaPalliative careFemalemedicine.symptombusinessMyoclonusMyoclonumedicine.drug
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Epidemiology and Characteristics of Episodic Breathlessness in Advanced Cancer Patients. An Observational Study

2016

Abstract Context Episodic breathlessness is a relevant aspect in patients with advanced cancer. Objectives The aim of this study was to assess the different aspects of this clinical phenomenon. Methods A consecutive sample of patients with advanced cancer admitted to different settings for a period of six months was surveyed. The presence of background breathlessness and episodic breathlessness, their intensity (numerical scale 0–10), and drugs used for treatment were collected. Factors inducing episodic breathlessness and its influence on daily activities were investigated. Results Of 921 patients, 29.3% ( n  = 269) had breathlessness and 134 patients (49.8%) were receiving drugs for backg…

MalePediatricsmedicine.medical_specialtyPalliative careActivities of daily livingTime FactorsEpisodic breathlessneSettore MED/41 - AnestesiologiaContext (language use)advanced cancer; dyspnea; Episodic breathlessness; opioids; palliative care; Anesthesiology and Pain Medicine; Neurology (clinical); Nursing (all)2901 Nursing (miscellaneous)DiseaseComorbidityepisodic breathlessness; advanced cancer; dyspnea; opioids; palliative care03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineNeoplasmsEpidemiologyActivities of Daily LivingmedicinePrevalenceHumansadvanced cancer030212 general & internal medicineKarnofsky Performance StatusGeneral NursingNursing (all)2901 Nursing (miscellaneous)Agedpalliative careEpisodic breathlessnessbusiness.industryEpisodic breathlessness; advanced cancer; dyspnea; opioids; palliative careopioidsCardiovascular Agentsrespiratory systemMiddle Ageddyspneamedicine.diseaseComorbidityAnesthesiology and Pain Medicine030220 oncology & carcinogenesisCardiovascular agentMultivariate AnalysisopioidObservational studyFemaleNeurology (clinical)business
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