A5053287560- Palliative Care and End-of-Life Issues
- Pain Management and Opioid Use
- Cancer survivorship and care
- Pediatric Pain Management Techniques
- Childhood Cancer Survivors' Quality of Life
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- Opioid Use Disorder Treatment
- Patient Dignity and Privacy
- Pharmacological Effects and Toxicity Studies
- Nausea and vomiting management
- Family and Patient Care in Intensive Care Units
- Anesthesia and Pain Management
- Diet and metabolism studies
- Patient-Provider Communication in Healthcare
- Head and Neck Cancer Studies
- Frailty in Older Adults
- Cancer, Stress, Anesthesia, and Immune Response
- Cancer Diagnosis and Treatment
- Ethics in medical practice
- Adipose Tissue and Metabolism
- Anesthesia and Sedative Agents
- Pain Management and Placebo Effect
- Male Breast Health Studies
- Clinical practice guidelines implementation
The University of Texas MD Anderson Cancer Center
2015-2025
Hospital de Câncer de Barretos
2015
Four Seasons
2013
Purpose Cancer-related fatigue (CRF) is the most common symptom in patients with advanced cancer. The primary objective of this prospective, randomized, double-blind, placebo-controlled study was to compare effect dexamethasone and placebo on CRF. Patients Methods cancer ≥ three CRF-related symptoms (ie, fatigue, pain, nausea, loss appetite, depression, anxiety, or sleep disturbance) 4 10 Edmonton Symptom Assessment Scale (ESAS) were eligible. randomly assigned either mg orally twice per day...
Abstract Purpose. Palliative care consultation services are now available in the majority of cancer centers, yet most referrals to palliative occur late. We previously found that term “palliative care” was perceived by oncology professionals as a barrier early patient referral. aimed determine whether service name change supportive associated with earlier referrals. Patients and Methods. Records 4,701 consecutive patients first before (January 2006 August 2007) after 2008 2009) were...
The vast majority of patients with cancer at the end life receive parenteral hydration in hospitals and no hospice, limited evidence supporting either practice. In this randomized controlled trial, we determined effect on symptoms associated dehydration, quality life, survival advanced cancer.We randomly assigned 129 from six hospices to (normal saline 1 L per day) or placebo 100 mL daily over 4 hours. primary outcome was change sum four dehydration (fatigue, myoclonus, sedation...
Patients with hematologic malignancies have reduced and later access to palliative care services (APCS) than do those solid tumors. It is unclear whether these patients develop a high symptom burden at the end of life that requires special interventions. The purposes this retrospective study were determine symptoms are less severe in on APCS severity associated early APCS.We studied records consecutive their first consultation (PC1). We collected information about demographics, cancer type,...
The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care patients with cancer. These Insights summarize and context the updated guidelines regarding hospice end-of-life (EOL) care. Updates 2017 include revisions to restructuring of algorithms that address important EOL concerns. were revised clearer guidance oncologists as they cancer who are approaching transition Recommendations interventions reassessment based estimated life expectancy...
Abstract Background. Palliative care (PC) referrals are often delayed for patients with hematologic malignancies. We examined the differences in attitudes and beliefs toward PC referral between solid tumor specialists how their perception changed use of service name “supportive care” (SC). Materials Methods. randomly surveyed 120 oncology at our tertiary cancer center to examine SC referral. Results. Of 240 specialists, 182 (76%) responded. Compared were less likely report that they would...
Palliative care has evolved to be an integral part of comprehensive cancer with the goal early intervention improve quality life and patient outcomes. The NCCN Guidelines for Care provide recommendations help primary oncology team promote best possible throughout illness trajectory each cancer. Panel meets annually evaluate update based on panel members' clinical expertise emerging scientific data. These Insights summarize panel's recent discussions highlights updates importance fostering...
Cancer cachexia is considered intractable, with few therapeutic options. Secondary nutrition impact symptoms (S-NIS) such as nausea may further contribute to weight loss by decreasing nutrient intake. In addition, treatable metabolic abnormalities hypogonadism, vitamin B12 deficiency, hypothyroidism, and hypoadrenalism could exacerbate anorexia muscle wasting in patients cancer cachexia. We determined the frequency type of contributors appetite loss, effect clinic on clinical outcomes.Review...
These guidelines were developed and updated by an interdisciplinary group of experts based on clinical experience available scientific evidence. The goal these is to help patients with cancer the best quality life possible throughout illness trajectory providing guidance for primary oncology team symptom screening, assessment, palliative care interventions, reassessment, afterdeath care. Palliative should be initiated augmented collaboration experts.
Abstract BACKGROUND: Cancer pain initiatives recommend using the personalized goal to tailor management. This study was conducted examine feasibility and stability of goal, how it compares clinical response criteria. METHODS: Records 465 consecutive cancer patients seen in consultation at Supportive Care Clinic were reviewed. Pain relief assessed as (≥30% or ≥2 point reduction) (pain ≤ goal). RESULTS: One hundred fifty‐two (34%), 95 (21%), 163 (37%) presented with mild (1‐4), moderate (5‐6),...
Abstract Clinicians have limited accuracy in the prediction of patient survival. We assessed probabilistic clinician survival (CPS) and temporal CPS for advanced cancer patients admitted to our acute palliative care unit, identified factors associated with accuracy. Eight physicians 20 nurses provided their estimation on admission by (a) approach, “What is approximate this (in days)?” (b) probability that will be alive (0%–100%)?” ≥24 hours, 48 1 week, 2 weeks, month, 3 months, 6 months....
The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care patients with cancer. are intended to guidance the primary oncology team integration of into oncology. Panel's seek ensure that each patient experiences best quality life possible throughout illness trajectory. Accordingly, outline practices screening, assessment, interventions, reassessment, and after-death care.
The NCCN Guidelines for Palliative Care provide interdisciplinary recommendations on palliative care patients with cancer. These Insights summarize the panel’s discussions and guideline updates from 2013 2014. include modifications/additions to screening assessment protocols, new considerations discussing benefits risks of anticancer therapy, approaches advance planning. Recent focus enhanced patient-centered seek promote earlier integration planning in oncology.
Abstract Objective: In a simultaneous care model, patients have concurrent access to both cancer-directed therapies and palliative care. As oncologists play critical role in determining the need/timing of referral programs, their understanding service ability communicate this with is paramount importance. Our study aimed examine oncologists' perceptions supportive program at M.D. Anderson Cancer Center, determine whether renaming “palliative care” “supportive influenced communication...
Elevated resting energy expenditure (REE) may contribute to weight loss and symptom burden in cancer patients.The aim of this study was compare the velocity loss, (fatigue, insomnia, anxiety, anorexia-combined score as measured by Edmonton Symptom Assessment Score), high-sensitivity C-reactive protein, survival among patients referred a cachexia clinic with hypermetabolism, elevated REE > 110% predicted, normal REE.A retrospective analysis 60 advanced evaluated for either >5% or anorexia who...
Despite increasing prevalence of palliative care (PC) services in cancer centers, most referrals to the service occur exceedingly late illness trajectory. Over years, we have made several attempts promote earlier patient access our PC program, such as changing name from supportive (SC). This study was conducted determine use PC/SC over past 8 years.We reviewed billing data for all encounters. We examined five metrics use: inpatient consultations a percentage hospital admissions, ratio...