Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Levorphanol (levo-3-hydroxy-N-methylmorphinan) is a strong opioid that is the only available opioid agonist of the morphinan series. Levorphanol was originally synthesized as a pharmacological alternative to morphine more than 40 years ago. It is considered a step-3 opioid by the World Health Organization (WHO) and has a greater potency than morphine. Analgesia produced by levorphanol is mediated via its interactions with mu, delta, and kappa opioid receptors. Levorphanol is also an N-methyl-D-aspartate (NMDA) receptor antagonist. There is evidence that levorphanol may inhibit uptake of norepinephrine and serotonin. Similar to morphine, levorphanol undergoes glucuronidation in the liver, and the glucuronidated products are excreted in the kidney. Levorphanol can be given orally, intravenously, and subcutaneously. ⋯ The long half-life of the drug increases the potential for drug accumulation. Levorphanol has clinical efficacy in neuropathic pain.
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Support Care Cancer · Mar 2007
Incident pain and analgesic consumption decrease after samarium infusion: a pilot study.
The aim of this pilot study was to observe the variations of pain intensity on movement and at rest and the variation of analgesic drug consumption in patients with prostate cancer and painful bone metastases treated with a single dose of 1.0 mCi/kg of samarium-153 (153-Sm) lexidronam. ⋯ In patients with bone metastases, pain on movement is a frequent and often difficult clinical problem to treat and the most frequent cause of breakthrough pain. In patients with painful multiple bone metastases due to prostate cancer, the infusion of a single dose of 1.0 mCi/kg of 153-Sm lexidronam may be considered an effective and safe treatment for pain either at rest or during movement.
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Support Care Cancer · Mar 2007
Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland.
This qualitative study was set out to explore experiences of care provision of 60 patients diagnosed with lung cancer and a carer of their choice ⋯ Data from the study point to the importance of heightening general practitioner awareness of potential signs and symptoms of lung cancer. Findings indicate the need to evaluate the benefits to patients and carers of rapid access to diagnostic tests and results and support the establishment of effective and streamlined supportive care pathways for patients with lung cancer.
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Support Care Cancer · Mar 2007
Nutrition intervention using an eicosapentaenoic acid (EPA)-containing supplement in patients with advanced colorectal cancer. Effects on nutritional and inflammatory status: a phase II trial.
The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement (EPA-ONS) on nutritional and inflammatory status, quality of life (QOL), plasma phospholipids (PPL) and cytokine profile, tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer (CRC) receiving chemotherapy. ⋯ Dietary counseling and the provision of EPA-ONS may result in maintenance of nutritional status and QOL, however randomized trials are required to evaluate the impact of EPA on toxicity from chemotherapy.
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Support Care Cancer · Mar 2007
Factors associated with place of death of cancer patients in the Mexico City Metropolitan area.
To improve the care of cancer patients by understanding the factors associated with the place of death. ⋯ Patients dying at home tended to be of older age, less educated, diagnosed with prostate, urinary tract or gastrointestinal cancers, and residents of the MCMA. Health planners should consider determinants of place of death when allocating hospital or home-based palliative care units.