Search results for "Palliative care."

Unexpected death on an acute palliative care unit

2015

Although most deaths in patients with advanced cancer are expected, no data are available on unexpected death (UD). This event can be really stressful for physicians who are unable to anticipate, prevent, or discuss UD, and for relatives who are not ready for such an acute emotional burden, despite previous good communication about the short-term prognosis. There is the need for more information, particularly in the setting of an acute palliative care unit where most patients are discharged to follow different therapeutic pathways, including continuing oncologic treatment, home care, or hospice.1,2 The aim of this prospective study was to assess the characteristics of patients who died unex…

Spinal metastases: Is stereotactic body radiation therapy supported by evidences?

2016

Stereotactic body radiotherapy (SBRT) is becoming widely adopted in the treatment of primary and secondary tumors. Spinal bone metastases are frequently discovered in cancer patients, and in the past have been usually treated with a palliative goal. Nevertheless, in some particular clinical settings, such as oligometastatic patients and/or those with a long life expectancy, spinal SBRT could be considered a valid therapeutic option to obtain long-lasting palliation and, when possible, with a curative goal. This review aims to summarize available clinical and dosimetric data of published studies about spinal SBRT.

Pattern and characteristics of patients admitted to a hospice connected with an acute palliative care unit in a comprehensive cancer center

2022

Purpose: Information about inpatient hospice activity is limited. No data exist about the pattern and the characteristics of advanced cancer patients admitted to a hospice connected to an acute supportive/palliative care unit (ASPCU). Methods: Data of hospice admissions were retrieved from the database where all data were prospectively collected. The Edmonton Symptom Assessment Scale (ESAS) and the use of analgesics and adjuvant were recorded at admission (T0), 1 week (T7), 2 weeks (T14), and the day before death (T-end). The use of palliative sedation and its indication, duration, and drugs end doses used were recorded. The number of hospice deaths, discharges, and hospice staying were rec…

Endoscopic palliative management of esophageal and tracheal rupture

2014

The increasing number of patients requiring intensive care and airway support has led to a growing recognition that significant short- and long-term morbidity may be associated with the use of artificial airways; this is despite significant improvements in the materials used in laryngeal tubes, which aim to decrease the trauma associated with long-term intubation. We present the first case, to our knowledge,of huge, nontraumatic, esophageal perforation, widely communicating with the trachea, and which was treated successfully with double endoscopic stent placement.

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

2010

Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up A. Okines, M. Verheij, W. Allum, D. Cunningham & A. Cervantes On behalf of the ESMO Guidelines Working Group* GI Clinical Trials Unit, Royal Marsden Hospital, Sutton, UK; Department of Radiation Oncology and Division of Cellular Biochemistry, The Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Surgery, Royal Marsden Hospital, London; Department of Medicine, Royal Marsden Hospital, Sutton, UK; Department of Hematology and Medical Oncology, INCLIVA, University of Valencia, Valencia, Spain

The role of tapentadol as a strong opioid in cancer pain management: a systematic and critical review

2017

The aim of this review was to assess the role of tapentadol given at medium-high doses in opioid-tolerant patients for cancer pain management in place of step-3 analgesics.A systematic literature search was performed out of which six studies and one secondary analysis provided data regarding tapentadol used as a step-3 analgesic for this review. Tapentadol, when used at ≥60 mg of oral morphine equivalents in opioid-tolerant patients with cancer pain, or passing from step-2 doses to ≥60 mg of oral morphine equivalents, was well tolerated and effective and could be considered as a flexible drug to be used for the management of moderate-to-severe cancer pain. The limited occurrence of gastroin…

Work-related burnout syndrome in physicians in Spain

2020

Abstract This article brings together the views of a working group to deliberate on burnout among physicians in Spain. The document is the result of the answers that different members of the group have prepared to different questions on the subject with conclusions derived from the discussion among all the participants. Burnout is an entity with a high incidence in physicians, with serious work, personal and economic repercussions, whose recognition as a disease is changing in recent years. Particularly affected are some specialties, such as Primary Care, Oncology, Intensive Care Medicine, and Palliative Care. The common factor being an increased qualitative or quantitative demand on the pr…

Dying With Dementia

2013

Advanced dementia is increasingly being regarded as a terminal disease (1, 2). Studies in English-speaking countries have led to the conclusion that the palliative care of patients with dementia at the end of their lives is now inadequately adapted to their special needs, not only for those dying at home, but also for those dying in hospitals and nursing homes (3, 4). Insufficient symptom control, failure to recognize that the patient is dying, and unnecessary and stressful interventions such as artificial nutrition or physical restraints are common (5, 6). Most of the pertinent studies in Germany have looked only at the symptom burden of persons dying of cancer in palliative care facilitie…

Application of palliative ventilation: potential and clinical evidence in palliative care.

2017

Transarterielle Chemoembolisation (TACE) des Hepatozellulären Karzinoms (HCC) bei Patienten mit Pfortaderthrombose - Erfahrungen

2007

PURPOSE: Comparative analysis of the course of disease in patients with initial diagnosis of portal vein thrombosis in HCC treated with sequential TACE. Evaluation of the efficacy and safety of the method in a selected patient cohort. PATIENTS AND METHODS: The study included 22 patients with HCC that were palliatively treated at least 3 times with TACE. All patients presented a portal vein thrombosis in the initial CT investigation. The TACE-procedure was carried out in regular intervals using a suspension consisting of a fixed dosage of Mitomycin C (10 mg) and 10-20 ml Lipiodol. Follow-up investigations were carried out with contrast enhanced Multislice-CT before and after TACE and control…