Current opinion in supportive and palliative care
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Review current literature in the field of chronic nondental facial pain as recent clinical research findings need to be put into practise. ⋯ There is an increasing awareness that facial pain is common and has similar risk factors to other chronic pain conditions. Some oral pain conditions are now being recognized as being probably neuropathic in origin rather than being due to psychological factors. A more biopsychosocial approach to management of these conditions is essential. The first international guidelines on management of trigeminal neuralgia have now been published and should help all clinicians seeing these patients.
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Curr Opin Support Palliat Care · Jun 2009
ReviewAdvances in the pharmacological management of breathlessness.
To explore advances in the pharmacological treatment of refractory breathlessness and the physiological evidence for treatments. ⋯ Opioids prescribed regularly can help to predictably and safely reduce breathlessness for people with a range of end-stage illnesses.
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Curr Opin Support Palliat Care · Jun 2009
ReviewPulmonary rehabilitation for dyspnea in the palliative-care setting.
Although pulmonary rehabilitation has reproducibly improved dyspnea and quality of life indices in patients with chronic obstructive pulmonary disease (COPD), its suitability to the palliative-care setting is not well established. Evolutions in exercise design, self-monitored home-based programs, and understanding of the patient populations that may benefit are rendering pulmonary rehabilitation more feasible for patients with significant impairment. In this review, we focus on the recent developments that translate most successfully into the palliative-care setting. ⋯ Recent innovations in pulmonary rehabilitation interventions and setting allow the flexibility to facilitate its incorporation into an individualized palliative plan of care. Appropriately tailored, pulmonary rehabilitation may provide additional opportunities to optimize functional capacity and reduce symptom burden.
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Curr Opin Support Palliat Care · Jun 2009
ReviewLung volume reduction surgery for the management of refractory dyspnea in chronic obstructive pulmonary disease.
This review describes the role of lung volume reduction surgery (LVRS) for the management of refractory dyspnea and other debilitating conditions in patients with chronic obstructive pulmonary disease. Recent studies, including a randomized trial comparing LVRS to medical therapy, are analyzed. ⋯ LVRS is an effective strategy in the treatment of properly selected patients with COPD, improving survival and quality of life, including exercise tolerance, dyspnea, oxygen requirement and functional status.
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Curr Opin Support Palliat Care · Jun 2009
ReviewAdvances in the management of diabetic peripheral neuropathy.
Over the past 5 years there have been significant advances in the pathogenesis and management of diabetic peripheral neuropathic pain (DPNP) and this review attempts to summarize these. ⋯ There has recently been a consensus document suggesting an evidence-based protocol for the management of DPNP and this report is highlighted.