Articles: palliative-care.
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J Pain Symptom Manage · Oct 2021
Multicenter Study Observational StudyClinical predictors for analgesic response to radiotherapy in patients with painful bone metastases.
Radiotherapy (RT) reduces pain in about 60% of patients with painful bone metastases, leaving many patients without clinical benefit. This study assesses predictors for RT effectiveness in patients with painful bone metastases. ⋯ This study supports previous findings that better performance status and type of cancer diagnosis predicts analgesic RT response, and new data showing that soft tissue expansion predicts RT response and that corticosteroids is a negative predictor for RT response in patients with painful bone metastases.
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Spinal bone tumors include a heterogeneous broad of primary or metastatic lesions that may present as incidental findings or manifest with painful symptoms and pathological fractures. Optimal management of spine bone lesions is often difficult and treatment algorithms are usually solidly based on surgery. We aimed to evaluate the contribution of trans-arterial embolization in this field, with particular attention to the procedure efficacy, technical difficulties and complications. ⋯ Percutaneous trans-arterial embolization has established as a highly useful minimally invasive procedure in the management of spinal bone lesions, particularly as adjuvant preoperative therapy and palliative treatment.
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Parkinson's disease is a progressive neurodegenerative disorder that negatively impacts the lives of affected people. The therapeutic benefits of treatment only decrease going forward from the time of diagnosis. Motor and non-motor symptoms alike create a heavy burden for patients and those involved in their care. Palliative care is utilized for patients with serious illnesses and when integrated into patients with Parkinson's disease, improves quality of life by addressing symptoms of discomfort, which ultimately reduces symptom burden to patients and alleviates caregiver stress. ⋯ Understanding the connections between the themes surrounding palliative care is crucial for successful integration in Parkinson's disease management. It is determined that integration of palliative care in patients with Parkinson's disease help to not only improve patients' experiences but also their caregiver's experiences throughout the disease trajectory. Further research should be conducted to address how palliative care will focus on alleviating caregiver burden and establish specific prognostication tools for Parkinson's disease patients.
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J Pain Symptom Manage · Oct 2021
Prevalence and Factors Associated with Will-to-Live in Patients with Advanced Disease: Results from a Portuguese Retrospective Study.
Will-to-live (WtL) is a complex and multifactorial dimension of end-of-life experience. Health care decisions on assisted suicide and euthanasia are rarely based on WtL evidence-based discussions. ⋯ The factors associated with lower WtL scores are consistent with previous studies, indicating that these patients experience a myriad of physical, psychological and existential symptoms requiring an interdisciplinary palliative care approach. These factors pertaining to WtL should be made known, as Portugal considers how to navigate death-hastening legislation.