Articles: palliative-care.
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J Cataract Refract Surg · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialDoes preservative-free lignocaine 1% for hydrodissection reduce pain during phacoemulsification?
To compare preservative-free 1% lignocaine with balanced salt solution (BSS) in alleviating pain during hydrodissection in phacoemulsification cataract surgery. ⋯ There was no significant difference in the pain scores in patients who received BSS or lignocaine 1% solution. Thus, we conclude that hydrodissecting with lignocaine 1% solution does not provide added pain relief during phacoemulsification.
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Gastrointestinal obstruction is associated with nausea, vomiting, and abdominal pain. Antisecretory agents can relieve these symptoms, even in the absence of surgical or mechanical intervention. These medical management approaches are outlined, and recommendations are made.
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Cardiology in the young · May 2000
Comparative StudyGrowth of children with a functionally single ventricle following palliation at moderately increased altitude.
The bidirectional Glenn and Fontan procedures are empirically performed as interim and definitive procedures in children with a functionally single ventricle. The optimal stage of palliation, nonetheless, remains unknown. During childhood, growth is a fundamental measure of response to therapy. ⋯ Late mortality and the incidence of heart transplantation were increased in patients who experienced a decrease in their rate of growth, defined as a negative change of more than one Z score in weight or stature, following the Fontan procedure. In conclusion, at moderately increased altitude, children with a functionally single ventricle grow more appropriately following the bidirectional Glenn procedure than following the Fontan procedure. A decrease in the rate of growth is associated with a poor prognosis following the Fontan procedure.
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The use of syringe drivers as a method of drug delivery to control symptoms in palliative care is a common and accepted practice, but one which has evolved rather than been subject to close multiprofessional scrutiny and guideline formation. There is evidence that adverse incidents may arise as a result of syringe driver use (Medical Devices Agency (MDA), 1998), for example, errors in drug calculations, drug stability, equipment failure (including disconnection) and the wrong rate of infusion. Inadequate user training, poor servicing of equipment and inadequate documentation and record keeping are all thought to be contributing factors (MDA, 1998). ⋯ The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of drugs and doses prescribed, evaluation of treatment responses and review of treatment regimens were also areas of concern. Guidelines for the use of syringe drivers in non-specialist hospitals are put forward.