Journal of palliative medicine
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To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. ⋯ Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.
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To retrospectively assess the feasibility and efficacy of bipolar radiofrequency ablation (RFA) of extraspinal osseous neoplasms performed under local anesthesia. ⋯ Bipolar RFA of osseous metastases is a safe and effective treatment for refractory bone metastases. Its feasibility under local anesthesia should broaden the indications.
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Comparative Study
Symptom burden and achievement of good death of elderly cancer patients.
The aim of this study was to compare the symptom burden and achievement of good death of elderly cancer patients with that of younger patients. ⋯ Older cancer patients need at least the same levels of palliative care; while they experienced generally lower levels of nausea and pain, some older patients experienced higher levels of dyspnea, fatigue, emotional distress, need for information, help with decision making, loss of hope and pleasure, and independence.
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Malignant ascites is a common complication seen in association with various types of neoplastic processes. Due to high recurrence rates, patients may require multiple paracenteses, which have associated complications such as increased risk of bleeding, infection, pain, and volume and electrolyte depletion. ⋯ The PleurX catheter can be used to manage malignant ascites in severely ill patients with metastatic cancer, with a high rate of procedural success and a low incidence of potentially serious adverse events, infections, or catheter-related complications.
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On January 1, 2011, the Centers for Medicare and Medicaid Services (CMS) began requiring U.S. hospices to conduct a "face-to-face" (F2F) assessment of eligibility for continued hospice care with patients entering their third certification period (180 days after initial enrollment). Understanding which patient populations require F2F assessment is important for evaluating the impact of the CMS regulation and gauging the appropriateness of the 6-month prognosis criteria for different patient groups. ⋯ Unlike hospice patients with cancer, patients with a primary diagnosis of dementia or debility are more likely to remain in hospice care beyond 6 months and require F2F recertification. Still, these patients need the services provided by hospice care and may be limited by the 6-month recertification criteria.