Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Jul 2008
Performance of a modified MASCC index score for identifying low-risk febrile neutropenic cancer patients.
This is a prospective and observational study comparing the efficacy of risk-assessment models in patients with neutropenic fever in a reference treatment center. The meaning of the complex infection was evaluated. ⋯ The MASCC risk-index score had high sensitivity and specificity to predict the absence of complications, but the PACI model was better than MASCC for predicting the absence of complications in this febrile neutropenic patients.
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Support Care Cancer · Jul 2008
ReviewThe existential plight of cancer: meaning making as a concrete approach to the intangible search for meaning.
Despite modern advances that have led to improved prognoses and symptom management, a cancer diagnosis continues to evoke images of pain, suffering, and death. ⋯ The meaning-making intervention is presented as one concrete approach to address the normative distress associated with the search for meaning within the context of cancer.
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Up to 70% of patients with cancer should be expected to experience pain during the cancer illness. This is clearly more likely as disease progresses. The World Health Organisation (WHO) cancer pain guidelines remain the key to following a simple and systematic approach to cancer pain control in approximately 80% of patients. ⋯ However, lateral thought when managing challenging cancer-related pain becomes even more critical. This paper reviews the approach to the approximately 20% of patients who do not respond to the standard WHO three-step analgesic ladder approach and of course, by definition this means in practice those patients with severe pain which is not controlled by morphine or alternative strong opioids. Such cancer pain can be broadly categorised as opioid irrelevant pain, opioid partially responsive pain, opioid unresponsive pain or pain resulting from excess opioid.