European journal of cancer care
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This module presents background and encourages personal reflection and learning on end of life care terminology, concepts and ethics for all healthcare staff working with adult cancer patients. Consideration is given to resuscitation issues, communication skills competence and end of life care pathways such as Gold Standards Framework and Liverpool Care Pathway for the Dying.
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Little has been published on the use of imaging in palliative care. This paper discusses the use of 'in-house' ultrasound at the bedside in a specialist palliative care unit. The aim of this paper is to evaluate the potential uses of bedside ultrasound in the hospice population with consideration of length of stay and cost. ⋯ All scans were done on the day of admission. This paper provides an anecdotal experience in improving clinical care and convenience to patients and offers a potential tool for future evaluation as a bedside aid to clinical management. The results indicate a potential for a reduction in length of inpatient stay.
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Eur J Cancer Care (Engl) · Nov 2009
Case ReportsMediastinitis and mediastinitis-like symptoms associated with mal-positioning of a Port-A catheter.
Mediastinitis is a life-threatening condition and would appear to have been rarely reported as arising as a central-venous catheter-associated complication. Here we report on one cancer patient featuring a Port-A catheter tip positioned within the innominate vein, who developed mediastinitis and mediastinitis-like symptoms subsequent to chemotherapeutic-agent infusion through this catheter. The relevant literature pertaining to this condition was reviewed, and the possible pathophysiology of the condition was discussed.
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Eur J Cancer Care (Engl) · Sep 2009
Randomized Controlled Trial Comparative StudyA randomized controlled trial of transcatheter arterial chemoembolization with lipiodol, doxorubicin and cisplatin versus intravenous doxorubicin for patients with unresectable hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is a major and often therapeutically frustrating oncological problem. A total of 100 patients with unresectable HCC were recruited and randomized to be treated with either transcatheter arterial chemoembolization (TACE) or systemic chemotherapy. Fifty patients were treated with TACE using lipiodol, doxorubicin and cisplatin, while 50 patients were treated with systemic doxorubicin alone. ⋯ In conclusion, the overall survival benefits of TACE and systemic doxorubicin are similar for patients with unresectable HCC amenable to either treatment. It is crucial to optimize the benefit-risk ratio of TACE. In this setting, serum albumin level is a candidate marker for selection of cases who may benefit from this procedure.
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Eur J Cancer Care (Engl) · Sep 2009
Comparative StudyThe effectiveness of chlorhexidine-silver sulfadiazine impregnated central venous catheters in patients receiving high-dose chemotherapy followed by peripheral stem cell transplantation.
Immuno-compromised patients are at high risk for all kind of infections. Unfortunately, they need central venous catheters (CVCs), which are associated with infectious complications. In this study we examined the effectiveness of chlorhexidine-silver sulfadiazine impregnated CVCs to prevent catheter-related infections in patients receiving high-dose chemotherapy followed by peripheral stem cell transplantation. ⋯ Catheter-related blood stream infections (CR-BSI) were also diminished, but this result was not statistically significant (RR 0.15, 95% CI 0.02-1.15; P = 0.06). The reduction in CC and CR-BSI did not diminish the incidence of fever. We conclude that the use of chlorhexidine-silver sulfadiazine impregnated CVCs provide an important improvement in the attempt to reduce CC and CR-BSI.