Journal of pain and symptom management
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J Pain Symptom Manage · May 2019
Randomized Controlled Trial Multicenter StudyTHE BURDEN OF OPIOID ADVERSE EVENTS AND THE INFLUENCE ON CANCER PATIENTS' SYMPTOMATOLOGY.
Opioids are frequently used for the treatment of moderate-to-severe pain and their use may produce a number of unwanted adverse events (AEs). ⋯ Opioid introduction induces various AEs that persist over time and worse patients' symptomatology. Moreover, there seems to be a different expression of the opioid toxicity among patients, and a possible interaction between AEs and the analgesic response. The balance between the opioids analgesic effect and induced toxicity is fundamental in deciding the best management for pain in cancer patients.
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J Pain Symptom Manage · May 2019
ReviewThe association between benzodiazepines and survival in patients with cancer: a systematic review.
Patients with cancer often experience distressing symptoms such as anxiety or dyspnea, which can be managed with benzodiazepines; however, concerns regarding the impact of these drugs on survival may dissuade prescribing and compliance. ⋯ Existing evidence shows no association between benzodiazepine use in patients with cancer and decreased survival. None of the studies evaluated the association between benzodiazepine use and survival in earlier stages of cancer, and the quality of studies retrieved signifies a need for further robust studies to draw more definitive conclusions. Further investigation in patients with cancer using well-designed, high-quality research with survival as a primary outcome should be conducted.
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J Pain Symptom Manage · May 2019
A prospective cohort study of factors associated with place of death among patients with late stage cancer in southern Africa.
Identifying factors that affect terminally ill patients' preferences for and actual place of death may assist patients to die wherever they wish. ⋯ Most patients preferred to die at home, but most died in hospital and fewer than half died in their preferred setting. Further research on modifiable factors, such as effective communication, access to palliative care and morphine, may ensure that more cancer patients in South Africa die wherever they wish.
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J Pain Symptom Manage · May 2019
Multicenter StudyBreakthrough cancer pain in patients with abdominal visceral cancer pain.
The objective of this study was to assess the characteristics of breakthrough cancer pain (BTcP) in patients with abdominal cancer pain, and the eventual factors associated with its presentation. ⋯ Patients with abdominal visceral BTcP represent a subgroup with specific features of BTcP, particularly those with predictable BTcP. Ingestion of food was the prominent trigger for BTcP, having a faster onset and a lower intensity. This group of patients more frequently used oxycodone/naloxone or no anti-inflammatory drugs. These findings suggest consequential therapeutic decisions.
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J Pain Symptom Manage · May 2019
Circadian rhythmicity as a predictor of quality of life in allogeneic hematopoietic cell transplant patients.
Quality of life (QoL) is increasingly recognized as an important outcome of cancer treatment. Previous studies have examined clinical predictors of QoL, but with the increasing prevalence of wearable sensors that monitor sleep and activity patterns, further investigation into whether these behaviors are predictive of post-treatment QoL is now feasible. Among patients receiving aggressive cancer treatment such as hematopoietic cell transplantation (HCT), analysis of circadian rhythms (24-hour patterns of sleep and activity) via wearable sensors is limited. ⋯ Our findings suggest that wearable sensor information is a promising method of predicting recovery of QoL after HCT. Additional studies are needed to confirm these findings in a larger sample.