Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Aug 2004
Case ReportsSuccessful treatment of Wernicke encephalopathy in terminally ill cancer patients: report of 3 cases and review of the literature.
Although Wernicke encephalopathy has been reported in the oncological literature, only one terminally ill cancer patient with Wernicke encephalopathy has been reported. Wernicke encephalopathy, a potentially reversible condition, may be unrecognized in terminally ill cancer patients. In this communication, we report three terminally ill cancer patients who developed Wernicke encephalopathy. ⋯ Intravenous thiamine administration dramatically improved the symptoms of delirium in all three patients. In terminally ill cancer patients, clinicians must remain aware of the possibility of Wernicke encephalopathy when patients with a poor nutritional status present with unexplained delirium. Early intervention may correct the symptoms and prevent irreversible brain damage and the quality of life for the patient may improve.
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Support Care Cancer · Aug 2004
Differences in physician-reported practice in palliative sedation therapy.
Although palliative sedation therapy is often required in terminally ill cancer patients, little is known about actual practice. The aims of this study were to clarify the physician-reported sedation practices and the factors influencing the sedation rates. ⋯ Physician-reported practice in palliative sedation therapy varied widely among institutions. The differences were mainly associated with the physicians' philosophy about a good death, physicians' belief about the effects of sedation on patient survival, and physicians' medical practice. Discussion should be focused on these divergent areas, and clear clinical guidelines are urgently needed to provide valid end-of-life care.
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Support Care Cancer · Jul 2004
Comparative StudyCost-minimization analysis of low-molecular-weight heparin (dalteparin) compared to unfractionated heparin for inpatient treatment of cancer patients with deep venous thrombosis.
Low-molecular-weight heparin (LMWH) has shown to be as effective as unfractionated heparin (UFH) in the treatment of deep venous thrombosis (DVT). Although the acquisition cost of LMWH is significantly greater than that of UFH, we hypothesized that once-daily dalteparin, a LMWH, could reduce treatment costs of cancer patients with DVT by eliminating anticoagulation monitoring and shortening hospitalization. ⋯ Savings realized from less anticoagulant monitoring and shorter hospitalization offset the higher acquisition cost of dalteparin. The dalteparin strategy is less expensive than the UFH strategy for the inpatient treatment of DVT among cancer patients.
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Support Care Cancer · Jul 2004
Impact of cancer patients' quality of life on that of spouse caregivers.
This study aimed to examine the correlation between quality of life (QOL) in cancer patients and that of their spouse caregivers and to identify factors that influence this correlation. ⋯ Social and functional aspects of patients' QOL play a significant role in determining the QOL of their spouse caregivers. The strength of association between patients' and spouse caregivers' overall QOL can be moderated by some factors.
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Support Care Cancer · Jun 2004
ReviewSystematic review of the efficacy of antiemetics in the treatment of nausea in patients with far-advanced cancer.
To systematically review studies of antiemetics used in the treatment of nausea in patients with far-advanced cancer. ⋯ Evidence supporting the existing consensus-based guidelines for management of nausea and vomiting in advanced cancer is sparse. Current approaches to treatment based on the neuropharmacology of the emetic pathway may be inappropriate in this setting. Well-designed studies of the impact of "standard" management and novel agents on nausea and vomiting in palliative populations are needed.