Palliative & supportive care
-
Palliat Support Care · Dec 2005
Review Case ReportsWernicke encephalopathy presented in the form of postoperative delirium in a patient with hepatocellular carcinoma and liver cirrhosis: a case report and review of the literature.
Although Wernicke encephalopathy has been reported in the oncological literature, it has not previously been reported in postoperative cancer patients. ⋯ In cancer patients, clinicians must always remain aware of the possibility of Wernicke encephalopathy, especially in patients with liver dysfunction, which decreases the ability to store thiamine in the liver. Early detection and intervention may alleviate the symptoms of delirium and prevent irreversible brain damage.
-
Palliat Support Care · Dec 2005
ReviewCaring for those who care for the dying: coping with the demands on palliative care workers.
The article reviews the complex and demanding field of palliative care, noting the sources of the stresses and strains that the health care workers often encounter. It illustrates the multidimensional needs of patients, the reasons why they and/or their families may hamper palliative care, and, mostly, what can be done to deal with and-better yet-prevent palliative workers' burnout.
-
Palliat Support Care · Dec 2005
Clinical TrialMethadone in the treatment of pain and terminal delirum in advanced cancer patients.
This prospective study documents the use of methadone as part of an opioid rotation strategy in patients with uncontrolled pain and severe delirium admitted for terminal care to a tertiary cancer palliative care hospital. ⋯ Our study suggests that methadone can be effective in the treatment of both refractory pain and what appears to be terminal delirium. Most patients in our group had at least a short-term improvement in mental status as well as significant and lasting improvement in analgesia.