The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jun 2009
Prospective evaluation of transition to specialized home palliative care in Japan.
The aim of this study was to clarify patients' characteristics and the level of symptom management in the transition to specialized home palliative care, and to examine prospectively real-time evaluation of both terminal cancer patients and their families. This study was conducted at one of the largest institutions offering specialized home palliative care in Japan. ⋯ Regarding patient characteristics at the time of referral to the specialized home palliative care service, patients referred from outpatient settings had more severe physical symptoms than patients referred from inpatient settings. The specialized home palliative care service could contribute to patients' symptom and families' psychosocial status.
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Am J Hosp Palliat Care · Jun 2009
Editorial CommentAn overview of constipation and newer therapies.
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Emergency physicians must be competent in caring for elderly women because they constitute the fastest growing segment of the population in the United States. Familiarity with acute geriatric gynecologic issues is crucial to providing satisfactory health care for these patients with complaints relating to incontinence, pelvic floor dysfunction, and other gynecologic conditions. ⋯ This article provides a systematic approach to emergency department management of common geriatric gynecological conditions. Anatomical and physiological changes are discussed, as well as the geriatric pelvic examination, malignancy, urinary tract infection, incontinence, pelvic organ prolapse, and vulvovaginitis.