Actualités

Children's needs when facing the death of a parent from cancer: part one.

2012-11-01 Fife Palliative Care Service, Cedar House, Whyteman's Brae, Kirkcaldy, Scotland, UK. catrionamacpherson@fife-pct.scot.nhs.uk A small exploratory study was conducted to identify the psychosocial needs of children facing the death and subsequent bereavement of a parent from cancer.

Treatment options in end-of-life care: the role of palliative chemotherapy

2012-11-01 Advances in medical science and technology, combined with the primary goal of medical care to restore or maintain health as far as possible, often result in the transition from active to palliative care being blurred.

Interprofessional working: communication, collaboration... perspiration!

2012-11-01 Palliative care is rarely delivered by one provider; for most patients their care will be managed by community and one or more hospital teams at the least. This can be problematic for patients, their family and friends, and health professionals.

Supportive management of patients with brain tumors

2012-11-01 Management issues for patients with brain tumors include peritumoral edema, symptomatic seizures, venous thromboembolism, headache, pain, fatigue and neuropsychological complaints. Vasogenic edema is typically ameliorated with the lowest dose possible of corticosteroid.

Opioid use in palliative care of children and young people with cancer.

2012-11-01 OBJECTIVE: Identify opioids prescribed, preferred routes, and doses among children with incurable cancer. STUDY DESIGN: Prospective survey with monthly questionnaires regarding patients 0 to 19 years old from oncology centers.

Optimizing opioid management in palliative care

2012-11-01 il n'y a pas de résumé.....c'est un numéro complet

Evidence for improving palliative care at the end of life: a systematic review.

2012-11-01 BACKGROUND: Many persons and their families are burdened by serious chronic illness in late life. How to best support quality of life is an important consideration for care. PURPOSE: To assess evidence about interventions to improve palliative and end-of-life care.

Examining the Fingernails When Evaluating Presenting Symptoms in Elderly Patients

2012-11-01 Human fingernails, located on the dorsal aspect of the terminal 40% of the distal phalanx of each finger, are complex structures involving 3 different layers: The nail plate (the nail). This is the keratinized structure, which grows throughout life; The nail bed (ventral matrix, sterile matrix).

Management of Opioid-Induced Side Effects

2012-11-01 Il n'y a pas de résumé car ceci est une formation avec des diapositives et du texte et il y a un vidéo possible

Prescribing opioids in renal failure.

2012-11-01 Opioids are commonly used in both cancer and noncancer pain. Many patients who require opioids have renal impairment. This can adversely influence the safety of opioids in these patients.

Methylphenidate in palliative care in cancer patient: a double-blind randomised trial versus placebo]

2012-11-01 The amphetamine, methylphenidate (Ritaline) has been proposed as being of interest in the treatment of asthenia in patients with advanced cancer. To evaluate this hypothesis a randomised controlled double-blind parallel-group national multi-centre trial is proposed versus placebo.

Palliative care for critically ill older adults: dimensions of nursing advocacy

2012-11-01 Overall, critical care nursing and medical teams are inadequately prepared to deliver palliative care for the critically ill geriatric patient.

Managing an Acute Pain Crisis in a Patient With Advanced Cancer: "This Is as Much of a Crisis as a Code"

2012-11-01 The assessment and management of an acute pain crisis in the setting of advanced illness is challenging.

Family meetings in palliative care: Multidisciplinary clinical practice

2012-11-01 Abstract Background: Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers.

Lesson of the Week: Life saving treatment for a "palliative care" patient

2012-11-01 A "palliative care" label should not prevent life saving treatment for an illness with reversible cause The first 150 words of the full text of this article appear below. The word palliative is used in different ways in different contexts.

Palliative Care Telephone Consultation:

2012-11-01 Background: Access to expertise in palliative management in areas not served by palliative care consultants is an ongoing challenge.

Interventional Approaches to Pain

2012-11-01 Interventional approaches remain a mainstay of chronic pain treatment despite the many challenges to the study of their efficacy. When less invasive analgesic modalities provide inadequate relief, these techniques often play a complementary role.

Pathophysiology of Pain

2012-11-01 Nature of pain Pain is described as an unpleasant sensation associated with a specific part of the body [1]. It is produced by processes that either damage, or are capable of damaging, the tissues.

Adjuvant Analgesics

2012-11-01 Adjuvant analgesics are a diverse group of drugs that were originally developed for a primary indication other than pain. Many of these medications are currently used to enhance analgesia under specific circumstances [1].

Bisphosphonates and osteonecrosis of the jaw: cause and effect or a post hoc fallacy?

2012-11-01 Background: An increasing amount of reports are being published suggesting a relationship between the use of bisphosphonates (BPs) and the development of osteonecrosis of the jaw (ONJ).

Guidance on the use of bisphosphonates in solid tumours: recommendations of an international expert panel

2012-11-01 Bisphosphonates (BP) prevent, reduce, and delay cancer-related skeletal complications in patients, and have substantially decreased the prevalence of such events since their introduction.

Considering the Ethics of Hope

2012-11-01 With the estimation of hope as beneficial, there follows also empirical literature concerning ways of managing hope.

Use of the Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program in the Hospice Setting

2012-11-01 Background: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program was designed to ensure the full range of patient treatment preferences are honored throughout the health care system.

An update on the use of antipsychotics in the treatment of delirium

2012-11-01 Objective: Delirium is the most common neuropsychiatric complication of medical illness, a medical emergency that needs to be identified and treated vigorously.

Assessing Families in Palliative Care: A Pilot Study of the Checklist of Family Relational Abilities

2012-11-01 Although families often play an integral role in palliative care, there are currently few measures to help clinicians gauge families' abilities to participate in this process.

Psychiatric Indications for Admission to an Inpatient Palliative Care Unit

2012-11-01 As inpatient palliative care units (IPCUs) have become more widespread, experience grows regarding the patients for whom they are best suited.

Surgical Management of Metastatic Bone Disease

2012-11-01 Metastatic bone disease is a major contributor to the deterioration of the quality of life of patients with cancer; it causes pain, impending and actual pathological fractures, and loss of function and may also be associated with considerable metabolic alterations. Operative treatment may be requir

Baclofen as an Adjuvant Analgesic for Cancer Pain

2012-11-01 Purpose: Baclofen is a g-aminobutyric acid receptor agonist commonly used for managing many types of neuropathic pain. The effect of baclofen on cancer pain has not previously been studied.

Controlled Sedation for Refractory Symptoms in Dying Patients

2012-11-01 Terminally ill cancer patients near the end of life may experience intolerable suffering refractory to palliative treatment. Although sedation is considered to be an effective treatment when aggressive efforts fail to provide relief in terminally ill patients, it remains controversial.

Opioid Rotation: The Science and the Limitations of the Equianalgesic Dose Table

2012-11-01 Opioid rotation refers to a switch from one opioid to another in an effort to improve the response to analgesic therapy or reduce adverse effects. It is a common method to address the problem of poor opioid responsiveness despite optimal dose titration.

Skin reactions to the new biologic anticancer drugs.

2012-11-01 AB Purpose of review: To review the clinical presentation and management of cutaneous side effects of some of the new targeted anticancer therapies.

Pharmacokinetic Drug Interactions in Palliative Care: Focus On Opioids

2012-11-01 Opioid analgesics are crucial for pain management in most patients receiving palliative care.

Hope in palliative care: An integrative review

2012-11-01 Objective: The objective of this review is to describe the current status of research on hope in palliative care. Methods: Integrative review was conducted to determine current knowledge on the topic. CINAHL and PubMed MEDLINE databases were used to find the articles relevant to this review.

Eye Donation in Sydney Metropolitan Palliative Care Units

2012-11-01 Organ donation is generally accepted within the medical profession as a beneficial practice with demand continuing to exceed supply. For patients who are dying from cancer opportunities for organ donation are generally limited to eye donation.

L’empathie : rencontrer l’autre fait souffrir

2012-11-01 La société actuelle promeut un droit à ne plus avoir mal. Pourtant, la complexité du phénomène de la douleur s’oppose à ce vœu, comme nous le montre l’empathie. En effet, l’imagerie cérébrale confirme que la relation empathique favorise la douleur, que la personne regardée soit douloureuse ou non.

What Should We Say When Discussing “Code Status” and Life Support with a Patient? A Delphi Analysis

2012-11-01 Background: Patients and clinicians often find it difficult to discuss wishes regarding cardiopulmonary resuscitation (CPR) or “code status.” Some authors have published effective communication styles, but there are currently no published guidelines for the content of a discussion about resuscitatio

Sédation en médecine palliative : recommandations chez l'adulte et spécificitées au domicile et en gériatrie

2012-11-01 Cet article présente les recommandations de bonnes pratiques retenues par un groupe d’experts pour la sédation pour détresse, ses spécificités en gériatrie et au domicile. Quatre questions ont été étudiées : quelle est la définition de la sédation pour détresse ?

La sédation pour détresse chez l'adulte dans des situations spécifiques et complexes

2012-11-01 Résumé La plupart des auteurs réservent la mise en oeuvre d’une sédation profonde maintenue jusqu’au décès aux patients dont la mort est attendue dans un bref délai, généralement de quelques heures à quelques jours.

Deathbed Phenomena: Its Role in Peaceful Death and Terminal Restlessness

2012-11-01 Dying patients and their caregivers frequently experience that which is known as deathbed phenomena, that is, visions of past deceased relatives or friends, religious figures, and a visionary language pertaining to travel.

Soigner les râles terminaux

2012-11-01 Nous revoyons la physiologie de la production et de l’élimination des liquides dans l’arbre pulmonaire.

Hope and Noncurative Chemotherapies: Which Affects the Other?

2012-11-01 Clarissa, a businesswoman whose youthful looks belie her 55 years, sits in front of me. Her husband stands behind her. She has been feeling more tired and reports right quadrant abdominal pain over the past few days. She looks at me anxiously as I study the results of her scans on my computer.

Wounds and Survival in Noncancer Patients

2012-11-01 Background: Currently available prognostic models for noncancer patients lack high levels of discrimination. Therefore, the quest for additional prognostic factors must continue.

A Systematic Review of Topical Treatments to Control the Odor of Malignant Fungating Wounds

2012-11-01 Context Malignant fungating wounds (MFW) result from cutaneous infiltration by carcinogenic cells. Fetid odor, profuse exudate, pain, and infection are common symptoms that add to the physical and psychological suffering of patients with MFW.