Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Nov 1996
Pain and symptom control for cancer patients at the University Hospital in Essen: integration of specialists' knowledge into routine work.
At the University Hospital of Essen, supportive care for patients with cancer and other painful diseases is carried out by an interdisciplinary ambulant pain clinic supported by a pain conference with delegates from all departments involved in the care of cancer patients as permanent members. More than 600 in- and outpatients per year are treated by this institution. This model tends to integrate supportive care into the overall therapeutic concept and routine work and to improve education in this field by bedside teaching and training of local specialists in every department. ⋯ Scientific research in the field of palliative care, including supportive care, is a further concern of the pain clinic. Evaluation of the model shows that the concept has been realized within a decentralized and interdisciplinary setting; it must, of course, be borne in mind that the staff of the pain control clinic are deeply committed to their work. In conclusion, the way supportive care is realized in Essen can be recommended for large hospitals, and especially for medical schools.
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Support Care Cancer · Sep 1996
CommentA retrospective study of the psychiatric management and outcome of delirium in the cancer patient.
This report describes the evaluation and treatment of delirium in the cancer patient in a major comprehensive cancer center. Ninety consecutive cases of delirium seen by the inpatient psychiatry consultation/liaison service were analyzed in a retrospective fashion to evaluate demographic information, alcohol use, central nervous system disease, coexisting medical disease, and past psychiatric history. Delirium cases were divided into hyperalert, hypoalert, and mixed subtypes. ⋯ Since the data represent patients who were referred for psychiatric treatment, this may explain the increased number of hyperalert deliriums and, therefore, the generalizability of the results is limited. Delirium in the cancer patient is particularly problematic given the coexisting medical problems these patients experience. Because the outcome of delirium is better when the duration is shorter, it is important for clinicians to be sensitive to early symptoms so that treatment can be implemented faster, leading to less morbidity and mortality.
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Support Care Cancer · Sep 1996
Randomized Controlled Trial Clinical TrialA double-blind, placebo-controlled trial of i.v. dolasetron mesilate in the prevention of radiotherapy-induced nausea and vomiting in cancer patients.
The aim of this work was to measure the safety and efficacy of single i.v. doses of dolasetron mesilate for the control of emesis caused by single high-dose (at least 6 Gy) radiotherapy to the upper abdomen. The double-blind, placebo-controlled, multicenter study stratified patients on the basis of being naive or nonnaive to radiotherapy. Patients with or without a history of previous chemotherapy were enrolled. ⋯ Complete response at the 0.3-mg/ kg dose was superior to results with the placebo (P = 0.050). Treatment-related adverse events were rare, mild to moderate in intensity, and evenly distributed across the four groups. Overall, dolasetron mesilate was effective and well-tolerated in the control of single, high-dose radiotherapy-induced emesis.
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Although haloperidol is mainly used for the medical treatment of delirium in cancer patients, there are no universally accepted guidelines for its usage. We accordingly assessed the usefulness in managing delirium of a haloperidol treatment regimen in ten delirious cancer patients. The results of this preliminary study suggest that, in the management of delirium, appropriate usage of haloperidol on the first day is important as it affects the dosage thereafter.
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Support Care Cancer · Jul 1996
Clinical TrialGranisetron plus dexamethasone in moderately emetogenic chemotherapy: evaluation of activity during three consecutive courses of chemotherapy.
In this study we evaluated the antiemetic activity of a combination of 3 mg granisetron in a short i.v. infusion followed by 12 mg dexamethasone i.v. in 64 patients with cancer receiving moderately emetogenic chemotherapy scheduled in a single day. No patient had previously undergone chemotherapy and three consecutive cycles were evaluated. Response to antiemetic treatment was graded as follows: complete response, no episodes of vomiting; major response, only one episode; minor response, two to four episodes; failure, more than four episodes. ⋯ The antiemetic and antinausea efficacy remained substantially unchanged during the second and third cycles of chemotherapy. Constipation and headache were the most frequent adverse events. In conclusion this antiemetic regimen appears very effective in preventing nausea and vomiting in moderately emetogenic chemotherapy.