Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2021
Case ReportsPalliative radiotherapy produced spectacular improvement in a terminally ill colorectal carcinoma patient with severe pain and duodenal bleeding.
Colorectal cancer has a devastating effect on the quality of life, and the treatment of active intestinal bleeding in colorectal cancer is a real challenge at the end of life. This case report presents a spectacular effect of an unusual palliative treatment strategy in a middle-aged home hospice patient with severe pain and persistent duodenal bleeding secondary to its neoplastic infiltration. Palliative radiotherapy (RT) significantly improved pain control, terminated the duodenal bleeding, and allowed successful treatment of deep vein thrombosis, previously impossible because of the bleeding. ⋯ In our patient, RT played a leading role in restoring general fitness and, accordingly, mental state improvement. Our case demonstrates that palliative RT may be a valuable treatment option in cases similar to ours. Still, careful assessment of risks and benefits is always mandatory.
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J Pain Symptom Manage · Feb 2021
What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19? A rapid survey.
Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. ⋯ Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
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J Pain Symptom Manage · Feb 2021
Randomized Controlled Trial Multicenter StudyA Question Prompt List for advanced cancer patients promoting advance care planning: a French randomised trial.
Advance care planning is essential to enable informed medical decisions to be made and to reduce aggressiveness in end-of-life (EOL) care. ⋯ Questions on PC and EOL issues in outpatient PC consultations were more frequent, and patient satisfaction was better when a QPL was made available before the consultation.
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J Pain Symptom Manage · Feb 2021
ReviewEffect of virtual reality therapy in reducing pain and anxiety for cancer related medical procedures: A systematic narrative review.
Virtual reality (VR) has emerged as a novel form of nonpharmacological analgesia therapy. We wished to review the use of VR to treat pain and anxiety in cancer-related medical procedures and chemotherapy. ⋯ There is inconclusive evidence on the significance of immersive VR in reducing pain (five studies) or anxiety (six studies) for patients with cancer undergoing medical interventions or receiving chemotherapy. Further research on the effect of immersive VR as a tool for medical procedures and/or patients with cancer undergoing treatment is required.
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J Pain Symptom Manage · Feb 2021
Randomized Controlled Trial Pragmatic Clinical TrialElectro-acupuncture for post-stroke spasticity: results of a pilot pragmatic randomized controlled trial.
People with spasticity that occurred between 30 days and one year after stroke onset with a baseline Modified Ashworth Scale (MAS) ≥1. ⋯ It is feasible to conduct a full-scale trial to precisely evaluate the effectiveness and safety of EA for treating poststroke spasticity; however, longer treatment and follow-up phases should be considered in the full-scale trial.