Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2012
Clinical TrialWhen expectations predict experience: the influence of psychological factors on chemotherapy toxicities.
Patients with cancer undergoing similar treatments experience variable severity and frequency of side effects not adequately explained by pharmacological mechanisms, suggesting psychological influence. ⋯ Findings support the growing contention that patient expectations influence experience, negatively impacting quality of life. As it is unethical to withhold treatment information, research into screening for at-risk patients and offering brief interventions to minimize Anxious Preoccupation could be one way to reduce overall side effect burden, perhaps in the case of many medical interventions.
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J Pain Symptom Manage · Jun 2012
Randomized Controlled Trial Multicenter StudyEffect of parenteral hydration therapy based on the Japanese national clinical guideline on quality of life, discomfort, and symptom intensity in patients with advanced cancer.
Although an evidence-based clinical guideline for parenteral hydration therapy was established in Japan, the efficacy of the guideline has not been assessed. ⋯ Guideline-based parenteral hydration therapy contributed to maintaining global QoL and provided satisfaction and a feeling of benefit without increasing discomfort and worsening symptoms and fluid retention signs in patients with advanced cancer.
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J Pain Symptom Manage · Jun 2012
Randomized Controlled TrialDetecting the emergence of chronic pain in sickle cell disease.
Sickle cell disease (SCD) is an inherited hematological disease marked by intense pain. Early in life the pain is episodic, but it becomes increasingly chronic in many cases. Little is known about this emergence of a chronic pain state. ⋯ Most SCD patients whose pain remits entirely between episodes are not in a chronic pain state, but some--those who are older and have a history of highly painful episodes--appear to be transitioning into it. These early signs of disturbed processing may aid clinicians seeking to forestall disease progression.
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J Pain Symptom Manage · Jun 2012
Assessing the quality of pain care in ambulatory patients with advanced stage cancer.
Pain is common among patients with advanced cancer despite the dissemination of clinical pain care guidelines. ⋯ There is room for improvement in the pain care of patients with advanced cancer. Additional research is needed to understand the reasons for poor performance.
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J Pain Symptom Manage · Jun 2012
Case ReportsA case of inaccurate prognostication after the ARCTIC protocol.
Therapeutic hypothermia (ARCTIC, or Advanced Resuscitation Cooling Therapeutics and Intensive Care protocol) is a widely recommended intervention to improve mortality and neurologic outcomes after cardiac arrest. However, neurologic outcomes are difficult to predict soon after cardiac arrest in the setting of hypothermia, as illustrated by this case report. A 60-year-old man had witnessed cardiac arrest at home. ⋯ However, several studies have found these indicators to be unreliable after hypothermia. This may be the result of sedatives, which can affect physical examination and electroencephalogram results, and delayed clearance. Because of the unreliability of prognostication tests within the first 72 hours of hypothermic protocols in the setting of sedation, it appears prudent in some cases to delay final prognosis discussions until at least six days postcardiac arrest and after neurologic evaluation is done with patients sedative-free.