Search results for "Palliative Care."
showing 10 items of 329 documents
The impact of home palliative care on symptoms in advanced cancer patients
2000
Physical symptoms, which are highly prevalent in patients with cancer, have a major impact on many aspects of quality of life, and the best possible quality of life is the principal aim of palliative care. Few studies have reported the impact of home care on pain and symptoms among cancer patients living at home. The aim of this study was to evaluate the impact of home palliative care given by an experienced team on symptoms in advanced cancer patients. A consecutive series of 373 patients who were referred to a home palliative care program in the period 1993-1995 were prospectively evaluated. Patients were enrolled for the presence of different symptoms (pain, nausea and vomiting, dry mout…
The use of pilocarpine in opioid-induced xerostomia
2001
Oral dryness can be a symptom of asystemic disease, an adverse effect of anticholin-ergic, antiadrenergic or cytotoxic drug treatment, orit can be due to local radiotherapy. Opioid use isstrongly associated with xerostomia, although themechanism for this remains unclear; in one studypatients receiving morphine were four times morelikely to have a dry mouth than patients taking otherdrugs known to cause xerostomia.
Improvement in survival of metastatic colorectal cancer: Are the benefits of clinical trials reproduced in population-based studies?
2012
To describe trends in survival of non-resectable metastatic colorectal cancer (MCRC) over a 34-year period in a French population-based registry taking into account major advances in medical therapy.3804 patients with non-resectable metastatic colorectal cancer diagnosed between 1976 and 2009 were included. Three periods (1976-96, 1997-2004 and 2005-09) were considered.The proportion of patients receiving chemotherapy dramatically increased from 19% to 57% between the first two periods, then increased steadily thereafter reaching 59% during the last period (p0.001). Median relative survival increased from 5.9 months during the 1976-96 period to 10.2 months during the 1997-2004 period but, d…
Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
2010
Anal cancer is strongly associated with human papilloma virus (HPV) infection. Using polymerase chain reaction (PCR), the presence of the HPV genome has been identified in 80%–85% of cases. Other important risk factors include human immunodeficiency virus (HIV), immune suppression in transplant recipients and cigarette smoking. Herpes simplex virus (HSV)may play a secondary role in disease progression.Dietaryhabits, chronic inflammatory diseases and the presence of haemorrhoids do not appear to predispose to epidermoid anal cancer. Previous (gynaecological, lymphoma or leukemia) or subsequent (e.g. lung, bladder, vulva, vagina or breast) malignancy is more likely in anal cancer patients. Th…
Investigation of an opioid response categorization in advanced cancer patients
1999
The aim of this study was to investigate a possible distinction in three categories of opioid response and to identify possible factors associated with a poor response. A prospective survey was carried out in 105 consecutive patients requiring morphine for at least 4 weeks before death. Mean pain intensity, opioid doses and symptom intensity at weekly intervals, pain syndromes, and the presence of psychological distress were assessed. Opioid escalation index (OEI%) was calculated from the parameters recorded. Three categories were considered, including (1) patients with slow increments of opioid dose and a mean analgesic 10-cm visual analogue scale (VAS) less than 4 (responders), (2) patien…
The use of sublingual fentanyl for breakthrough pain by using doses proportional to opioid basal regimen.
2013
Abstract OBJECTIVE: The aim of this study was to prospectively assess the efficacy and safety of sublingual fentanyl (SLF) in doses proportional to opioid doses used for background analgesia for the treatment of BTP of cancer patients. METHODS: A sample of patients admitted to an acute palliative care unit, presenting breakthrough pain (BTP) episodes and receiving stable doses of opioids for background pain was selected to assess the efficacy and safety of SLF used in doses proportional to the basal opioid regimen used for the management of BTP. For each patient, data from four consecutive episodes were collected. For each episode, nurses collected changes in pain intensity and adverse effe…
Ineffectiveness of dextromethorphan in cancer pain
1998
Experimental studies have indicated that N-methyl-D-aspartate (NMDA) receptor antagonists may be effective analgesics in a wide variety of chronic pain states. The mechanism is presumed to be related to decreased firing of dorsal horn neurons after constant repeated C-fiber stimulation. Dextromethorphan (DM), a potent NMDA antagonist with a good safety profile, may be a promising agent for the treatment of persistent pain. An open-label randomized trial was designed to examine the effects of combining DM with NSAIDs, dextropropoxyphene, or morphine in cancer patients with pain. Patients who required a change in the step of the World Health Organization's (WHO) analgesic ladder because of a …
The use of opioids for breakthrough pain in acute palliative care unit by using doses proportional to opioid basal regimen.
2010
OBJECTIVES: To determine the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain (BP). METHODS: In 66 patients consecutive patients admitted to a pain relief and palliative care unit, the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain (BP) were assessed. The choice of the opioid to be administered as rescue medication was based on the characteristics of patients, clinical stability, compliance, preference, and so on. For each episode, nurses were instructed to routinely collect changes in pain intensity and emerging prob…
Survival of patients with spinal muscular atrophy type 1.
2013
BACKGROUND: Spinal muscular atrophy type 1 (SMA1) is a progressive disease and is usually fatal in the first year of life. METHODS: A retrospective chart review was performed of SMA1 patients and their outcomes according to the following choices: letting nature take its course (NT); tracheostomy and invasive mechanical ventilation (TV); continuous noninvasive respiratory muscle aid (NRA), including noninvasive ventilation; and mechanically assisted cough. RESULTS: Of 194 consecutively referred patients enrolled in this study (103 males, 91 females), NT, TV, and NRA were chosen for 121 (62.3%), 42 (21.7%), and 31 (16%) patients, respectively. Survival at ages 24 and 48 months was higher in …
Safety and effectiveness of intravenous morphine for episodic (breakthrough) pain using a fixed ratio with the oral daily morphine dose
2003
Breakthrough pain is normally severe in intensity and has a rapid onset. The availability of supplemental doses of opioids (rescue medication) in addition to the continuous analgesic medication is the main treatment suggested to manage these pain flares. The intravenous (i.v.) route may provide analgesia fast enough, but has never been assessed in clinical studies. The aim of this open-label study was to verify the safety and effectiveness of an i.v. dose equal to one-fifth the calculated equianalgesic total daily dose in advanced cancer patients with episodic pain. A consecutive sample of 48 cancer patients treated with oral morphine, who reported an acceptable basal analgesia and reported…