Gan to kagaku ryoho. Cancer & chemotherapy
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Patients with malignancies are subject to developing a set of complications that require emergency evaluation and treatment. Emergencies in the cancer patients are particularly complex. Since the severity of emergency situations varies individually, the appropriate treatment should be determined based on the clinical condition of individual patients. ⋯ An oncogenic emergency involving respiratory malignant disease is rare, but special medical knowledge and skills are required. Therefore, we should train for that situation in a medical examination. In this review, we suggest the diagnosis and initial therapy for common emergencies involving respiratory malignant disease, such as severe airway obstruction, massive hemoptysis, pneumothorax, and hemoneumothorax.
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Gan To Kagaku Ryoho · Dec 2008
[Problems of home hospice care related to duration--home hospice care for cancer patients who died at home within a week after the start of home hospice care].
The following results regarding the frequencies of home visits by nurses were obtained by comparing a group consisting of those who died within a week after the initiation of home hospice care (Short cases) and of those who had lived more than two weeks after starting the home hospice care (Control cases). 1) The frequencies of both scheduled and emergency home visits in Short cases were statistically higher than in Control ones. 2) Among the nurse's visits, scheduled home visits were of great importance leading not only to lessening the frequency of emergency visits but also to the palliation of anxiety for the patient/family. If the scheduled home visits were done appropriately, the frequency of emergency visits for the Short cases was just as low as for the Control cases. Thus, we reached the conclusion that home hospice care should start as soon as possible and that prolongation of inpatient care should be avoided.
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Gan To Kagaku Ryoho · Dec 2008
[Clinical effectiveness of anti-cholinergic agents for respiratory impediment in the home palliative care setting].
Dyspnea is one of the most common problems we encounter in the palliative care setting of patients with life-threatening illness including malignancy. Dyspnea is considered especially a troublesome symptom in the management of in-home hospice care services. ⋯ According to the outcome of this study, anti-cholinergic drugs may be effective for alleviating the suffering of terminally-ill patients due to dyspnea. Further investigation would be expected to clarify the usefulness of anti-cholinergic agents in the field of palliative care.
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Gan To Kagaku Ryoho · Dec 2008
[The outpatient palliative care conference aimed at "home palliative care shift"].
The association of doctors of Shizuoka City started a conference (S-NET) for cancer diagnosis and treatment in order to enhance a home palliative care for terminal cancer patients. At the same time, we introduced a system called "home palliative care shift" for inpatients. However, we felt that an intervention was necessary at the earliest stage of home palliative care due primarily to difficulties our home palliative team faced in its intervention for inpatients to "home palliative care shift." The outpatient palliative conference started to begin centering in the outpatient chemotherapy room because we thought it was important to have a seamless transition for terminal cancer patients. ⋯ Through the participation of multiple different back ground professionals at the time, the patients were treated well with better understandings. Furthermore, by sharing the patient's objective and information, we could enhance some relationship with the patient as well as going along with patient intensions what they want us to do for them at the final moment of their life. We thought that the system that verifies patient's intentions at the earliest stage of home palliative care was clearly needed most.