Current opinion in supportive and palliative care
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Curr Opin Support Palliat Care · Jun 2013
ReviewModels of delivering palliative and end-of-life care in India.
India is home to one-fifth of the global population. This review aims to explore the structures, functions and relevance of palliative care services in India. Although palliative care has been initiated in India almost 3 decades ago, development of services has been patchy and inadequate. Some of the regions are well covered, but most are not. The Indian palliative care scene, with its diversity in approach and delivery of services, can offer valuable lessons to service development in low-income and middle-income countries. ⋯ The state of palliative care in India is discussed with particular attention to the successful Kerala Model in palliative care. Lessons learned from the experiment in Kerala are listed.
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Cancer pain management is in continuous innovation and new data are available that could change the therapeutical approach and guidelines. ⋯ The findings reported in this review provide new ideas to be developed in further studies to confirm or not confirm some suggestive data.
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Curr Opin Support Palliat Care · Mar 2013
ReviewIdentifying treatment burden as an important concept for end of life care in those with advanced heart failure.
The concept of treatment burden is receiving increasing attention and this review seeks to show that treatment burden is an important issue for end-of-life care in those with advanced heart failure. ⋯ Treatment burden has the potential to be an important barometer of quality of care from the patient perspective in advanced heart failure.
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Curr Opin Support Palliat Care · Mar 2013
ReviewMalignant wound management in advanced illness: new insights.
This article describes why this review is timely and relevant. To report on the recent research, which advances our understanding and practice of palliative wound care (wound-related pain and symptom management or wound palliation). ⋯ This article describes the implications of the findings for clinical practice or research. The findings of the wound malodour survey indicate that approaches to managing malodour are wide ranging, but ineffective. Collaborate research and development is needed with industry into interventions to combat malodour, which are based on the causal agents. The growing evidence of the effectiveness of electrochemotherapy, as an uncomplicated palliative treatment and method of managing symptoms, offers palliative care clinicians a means of managing the otherwise relentless progression of cutaneous malignancy.
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Curr Opin Support Palliat Care · Mar 2013
ReviewEnd-of-life care in adults with congenital heart disease: now is the time to act.
There are increasing numbers of adults with congenital heart disease (CHD) and these patients remain at long-term risk of complications and premature death. This review focuses on the changing picture of adult CHD with more complex patients surviving, the challenges of balancing life-prolonging intervention, the barriers to discussing the end-of-life (EOL) issues and draws on the experience of other specialities in managing young patients. ⋯ These patients require an early and proactive approach to EOL discussions, and the unique needs of young patients should be recognized. Further research is needed to develop local and national guidelines for the palliative care approach in these patients.