Search results for "Palliative care."
showing 10 items of 329 documents
Preoperative imaging of hilar cholangiocarcinoma: surgical evaluation of standard practises.
2004
UNLABELLED It was the goal of this study to compare the results of the preoperative diagnostic workup (ERC, MRC, and PTC) with the tumor extent of the surgical specimen in patients with hilar cholangiocarcinoma (hilCC). PATIENTS AND METHODS Between 9/97 and 12/2002 82 patients with hilCC were treated at our institution. In 59 patients tumor resection was feasible. Preoperative ERC, MRC and PTC - blinded for the idendity of the patients - were analysed retrospectively and compared with the surgical specimen. RESULTS PTC resulted in significantly superior visualization of the bile ducts including the hilar lesion compared to ERC and MRC (p < 0.01). ERC, MRC and PTC were correct in predicting …
The basis, technique and indication for cryosurgery in tumours of the oral cavity and face
1975
The fundamentals of clinical application of crysurgery with very deep freezing of tissues is based on the necrotising effect of extreme cooling. The freezing of extracellular and intracellular free fluid leads to irreversible cell damage, because of a shift of electrolyte concentration to toxic values, and a direct lesion of internal cellular structures. The lesion due to cold occurs as a clear demarcation from the healthy surrounding, almost completely painlessness, and rapid healing without complication. For clinical application in the head and neck, there are cooling instruments fitted with specially shaped, exchangeable probe heads. Convincing results were achieved in the cryosurgical t…
"Card sorting" : a tool for research in ethics on treatment decision-making at the end of life in Alzheimer patients with a life threatening complica…
2011
Abstract Background End stage dementia is a particularly difficult aspect of care for patients with Alzheimer's disease and related dementias. In care institutions, caregivers and family are concerned by treatment decision-making for an acute life threatening complication occurring in Alzheimer patients at the end of life. How should the best treatment pathway be decided: to treat or not to treat? Which arguments are used for decision-making? These are mainly ethical questions which are currently difficult to express and investigate. Methods/Design Cross sectional multicentre study of clinical cases involving 67 health centres (university hospitals, general hospitals, local hospitals and ho…
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.…
Ergebnisse und Komplikationen von 616 perkutanen transhepatischen Gallenwegsdrainagen
1989
During nine years, percutaneous transhepatic biliary drainage was carried out 616 times on 563 patients in the Department of Radiology, University of Mainz Medical School. 50.3% were pre-operative and 39% were palliative. More than 80% were necessitated by malignant lesions. Subsequent improvements in biochemical measurements were observed in 82.4% of patients. Complications of the procedure led to the death of five patients (0.8%) and required surgery in nine patients (1.5%). The following complications were observed: biliary peritonitis in 0.6%, sepsis in 1.9%, bleeding in 1.9% and fever higher than 38 degrees C in 16.2%.
Effectiveness of interventions to improve cancer treatment and follow-up care in socially disadvantaged groups.
2019
Objective To identify and characterize the interventions that aimed to improve cancer treatment and follow-up care in socially disadvantaged groups. To summarize the state of the art for clinicians and researchers. Methods We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were randomized controlled trials and quasi-experimental studies with a control group (usual care or enhanced usual care) conducted in Organization for Economic Co-operation and Development (OECD) member countries and published until 2016. Results Thirty-one interventions were identified, the majority of which were conducted i…
Telemedicine during Covid-19 pandemic: Advantage or critical issue?
2020
Telemedicine offers a support to traditional medicine, delivering clinical services when distance is a critical factor. Although this tool does not replace a medical examination, during Covid-19 pandemic, it reduces the spread of infection and avoids the need for a patient’s visit. It is useful in the management of chronic disorders or for patients undergoing palliative treatment. The University Hospital of Palermo has applied this in cases of chronic illness caring for patients who cannot stop their treatment, such as Department of Onco-Haematology, Internal Medicine, Dermatology, etc. The Department of Legal Medicine of Palermo, in particular, is also using telemedicine to manage medico-…
The anesthesiologist and end-of-life care
2012
Purpose of review Anesthesiologists may face problematic situations when patients are close to death, in which clinical problems, decision-making processes, and ethical issues are often interconnected and dependent on each of them. The aim of this review is to assess the recent literature regarding the anesthesiological role for advanced cancer patients. Recent findings Palliative sedation in the dying patients, end-of-life problems in the ICU, and pain control in advanced cancer patients have been the subject of recent research. All these issues have shown that anesthesiologist would be expert in the field of pain and symptom control at the end of life. End-of-life care problems are common…
The lower the expectations in controlling the symptoms of advanced cancer patients, the better the clinical response.
2020
Aim The aim of this study was to compare patients' global impression (PGI) and the achievement of personalised symptom goal response (PSGR), after a comprehensive palliative care treatment in advanced cancer patients having high (HPSG) and low symptom goals (LPSG). Patients and methods Advanced cancer patients admitted to palliative care units rated symptoms intensity by the Edmonton Symptom Assessment Score (ESAS) at admission and then after one week of comprehensive palliative care treatment. For each symptom, patients were divided into two groups, according to their patient symptom goal (PSG): ≥4 (HPSG), and 0-2 (LPSG). PGI and PSGR were evaluated after one week of palliative care. The M…
Causes and place of death in Italian patients with amyotrophic lateral sclerosis
2010
Objectives - To determine the causes and place of death in a cohort of Italian patients with amyotrophic lateral sclerosis (ALS). A better understanding of the likely causes of death in ALS might improve the palliative care at the end-of-life, whereas knowing the place of death will help to verify the need for highly specialized care services, e.g. hospice and nursing home. Patients and methods - Between 2000 and 2008, 182 ALS patients (onset: spinal, 127; bulbar, 55; M/F: 1.6) were followed in a single ALS Tertiary Centre in Palermo, Sicily, Italy until death. Medical data for each individual patient were recorded in a large database throughout the disease course. Information concerning ca…