Articles: palliative-care.
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To identify and synthesize evidence from studies examining the quality of care of dying patients in both specialist and general practitioner care. ⋯ There is limited evidence of improvements in the care of selected cancer patients, and a dearth of evidence concerning patients dying from other, more common causes. The methods of research used to date are of limited current utility and new methods are required.
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This study was a retrospective examination of adolescents' use of non-pharmacologic methods to manage menstrual discomfort. ⋯ It is possible that some methods are used because they have a physiologic impact on pain (e.g. heat), whereas others (e.g., distraction) provide a sense of comfort and control. Further research is necessary to examine the determinants of why and when certain management strategies are used by adolescents.
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Eur J Cardiothorac Surg · Dec 1999
Comparative StudyMesothelioma--VATS biopsy and lung mobilization improves diagnosis and palliation.
Mesothelioma is an increasingly frequent malignancy in which diagnosis is often delayed and disease diagnosed at an advanced stage. Earlier diagnosis and therapeutic intervention that can control recurrent pleural effusion may improve outlook and survival. ⋯ VATs provides adequate tissue for histological diagnosis where other methods fail. At the same operative sitting it provides a therapeutic intervention that allows drainage of effusion cytoreductive pleurectomy and lung mobilization in a significant number of cases. Where the pleural space can be closed this results in significantly fewer hospital admissions and appears to improve quality of life and length of survival. The price is a longer hospital stay due to prolonged air leak.
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Am. J. Gastroenterol. · Dec 1999
Case ReportsPalliative transhepatic biliary drainage and enteral nutrition.
Simultaneous intestinal and biliary obstruction is a rare but agonizing complication of metastatic abdominal cancer. Although endoscopic procedures exist that relieve jaundice or restore enteral nutrition, they can be impossible to perform for technical or anatomical reasons. We propose a palliative approach for these patients that includes transcutaneous common bile duct drainage, progressive dilation of the transhepatic channel over 1 wk, and, finally, insertion of a permanent silicon catheter that drains bile into the duodenum and is combined with an enteral feeding line. ⋯ As a result, the patients chose to return to home care with enteral nutrition and pain medication. The creation of a transhepatic access for simultaneous enteral bile drainage and nutrition is a technically simple procedure that causes little discomfort to a terminally ill patient. It relieves the symptoms of tumor obstruction, and the option of enteral nutrition and medication can obviate the need for intravenous infusions.
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To develop an outcome measure for patients with advanced cancer and their families which would cover more than either physical symptoms or quality of life related questions. To validate the measure in various specialist and non-specialist palliative care settings throughout the UK. ⋯ The POS has acceptable validity and reliability. It can be used to assess prospectively palliative care for patients with advanced cancer.