Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · May 1994
Prevention of aspiration pneumonia during long-term feeding by percutaneous endoscopic gastrostomy: might cisapride play any role? An open pilot study.
The risk of aspiration during tube feedings has been reduced but not abolished by percutaneous endoscopic gastrostomy (PEG). This open study was planned to evaluate whether cisapride may play some role in preventing aspiration in long-term enteral feeding via PEG. A group of 29 patients, unable to swallow because of head and neck cancer (14 cases) or neurological disorders (15 cases) entered the study; 7 neurological patients, fed via nasogastric tube before PEG placement, had suffered from aspiration pneumonia during nasogastric feeding. ⋯ No episode of probable/possible aspiration pneumonia was observed during the follow-up. Two neurological patients with involuntary movements had rupture of the feeding tube, which was replaced without complications. These results support the hypothesis that cisapride might play some role in the prevention of aspiration in patients fed via PEG, and justify the planning of some controlled, double-blind trials to verify such a hypothesis.
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Support Care Cancer · May 1994
Comparative StudyOn the relationship between nausea and vomiting in patients undergoing chemotherapy. Italian Group for Antiemetic Research.
In comparative trials on antiemetic efficacy of different regimens, the positive correlation between the probabilities of vomiting and of nausea could hide some confounding effect. Our work seeks to detect such effects. The data from two large studies on prevention of cisplatin-induced emesis were re-analyzed using two multifactorial logistic models. ⋯ Instead, in the second study, the greater efficacy of Mtc/Dex/Dip in preventing both nausea and vomiting was confirmed. The results indicate that, when a correlation between two responses is detected, multifactorial analyses should be performed to identify the possible presence of some confounding effect. The proof that the presence/absence of vomiting is a confounding factor for the relationship between the different efficacy of the two antiemetic regimens for complete protection from nausea, highlighting the same efficacy of the two therapies in preventing nausea, supports the hypothesis of the existence of two kinds of nausea, one independent of vomiting, the other concomitant with it.
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Support Care Cancer · May 1994
Case ReportsClinical application of nebulized opioids for treatment of dyspnoea in patients with malignant disease.
This article describes our experience in the clinical use of nebulized opioids for the management of dyspnoea in patients with terminal cancer by reviewing three specific patient case studies in which this treatment was found to be both safe and effective in controlling breathlessness. The patients were treated with morphine, hydromorphone or anileridine in various doses according to their prior use of opioids. Additional formal studies are being initiated at this Centre.