Current opinion in supportive and palliative care
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Classification of neuropathic pain has been based on disease entities, anatomical localization or histological observations. There is now recognition from clinical investigations that neuropathic pain is not a monolithic entity, but instead presents as a composite of pain and other sensory symptoms. ⋯ Application of quantitative sensory testing and questionnaires can aid in more versatile descriptions of neuropathic pain symptoms. If it were possible to characterize the concert of the distinct mechanisms and symptoms that operate in one individual patient, an optimal polypharmacotherapy that addresses the specific combinations of mechanisms may be established for each patient.
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Curr Opin Support Palliat Care · Mar 2008
ReviewTreatment of delirium in supportive and palliative care.
The past few years have witnessed increased research into delirium treatment and related issues, leading to better management (e.g. improved detection) and better understanding of phenomenology and pathophysiology. Many treatment and prevention trials have been conducted. ⋯ Use of validated detection instruments is now standard procedure in both specialized clinical practice and research. Although haloperidol remains the mainstay of treatment, recent trials have begun to discriminate between the use of different agents and pharmacological approaches.
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Curr Opin Support Palliat Care · Mar 2008
ReviewOptimizing antiemetic therapy in multiple-day and multiple cycles of chemotherapy.
Only a few studies have investigated the effect of antiemetic therapy in patients treated with multiple-day or multiple cycles of chemotherapy. The present review will assess the available data, highlight the current recommendations and draw attention towards the remaining problems in this field of antiemetic treatment. ⋯ The development of the NK1-receptor antagonist aprepitant has significantly improved the antiemetic control in patients treated with multiple cycles of chemotherapy. Far too many patients still experience considerable emetic side effects. The effect of aprepitant in multiple-day chemotherapy has yet to be defined. The effect of new antiemetic agents such as palonosetron and olanzapine also needs to be investigated in randomized trials.