The Journal of community and supportive oncology
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J Community Support Oncol · Apr 2014
Late referral to palliative care consultation service: length of stay and in-hospital mortality outcomes.
Palliative care services in the United States are increasing in their prevalence but continue to vary in their implementation, with different referral policies and timing of patient access to services. ⋯ Our study suggests that late referrals may have a marked negative impact on health outcomes, which argues for the design and implementation of hospital policies that encourage early referral to palliative care for advanced cancer patients.
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J Community Support Oncol · Mar 2014
An analysis of the variability of breakthrough pain intensity in patients with cancer.
The management of breakthrough pain in patients with cancer (BTPc) generally includes an initial titration of breakthrough pain medication to an effective dose, followed by the use of that dose in all subsequent episodes. This strategy presumes that an individual patient has a degree of consistency of pain during repeat episodes; however, that presumption has not been formally assessed. ⋯ The study was funded by Archimedes Development Ltd.
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J Community Support Oncol · Feb 2014
A rare case of ovarian carcinosarcoma with neuroendocrine differentiation.
A 60-year-old woman presented with worsening right lower extremity swelling for 2 days. The patient had no history of trauma or prolonged immobilization and denied further symptoms, including lower extremity pain, fever, dyspnea, chest pain, and abdominal pain. The patient's medical history included chronic hepatitis C secondary to intravenous drug use, a history of deep venous thrombosis 25 years prior to her presentation, and a history of right-sided breast cancer 20 years prior to that was treated with lumpectomy, radiation therapy, chemotherapy, and tamoxifen (discontinued by the patient after 3 years). The family history was unknown as the patient was adopted.
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J Community Support Oncol · Feb 2014
Bridging the gap: a palliative care consultation service in a hematological malignancy-bone marrow transplant unit.
There is often a lack of collaboration between hematological malignancy-bone marrow transplantation (HM-BMT) units and palliative care (PC) services. In this paper, we describe a quality improvement project that sought to close this gap at a tertiary care hospital in Pittsburgh, Pennsylvania, from August 2006 to May 2010. ⋯ The successful integration of a PC team into a hematological malignancy unit suggests great potential for positive interdisciplinary collaboration between these two fields.