Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2019
Clinical TrialCebranopadol, a novel first-in-class analgesic drug candidate: first experience with cancer-related pain for up to 26 weeks.
Pain is one of the most prevalent symptoms associated with cancer. Strong opioids are commonly used in the analgesic management of the disease, but carry the risk of severe side effects. Cebranopadol is a first-in-class drug candidate, combining nociceptin/orphanin FQ peptide and opioid peptide receptor agonism. For cancer patients, frequently experiencing multimorbidities and often exposed to polypharmacy, cebranopadol is easy to handle given its once-daily dosing, the small tablet size that enables swallowing, and the option to flexibly titrate to an effective dose. ⋯ Our data suggest that cebranopadol was safe and well tolerated when administered for up to 26 weeks in patients with chronic cancer-related pain who were previously treated with cebranopadol or morphine prolonged release.
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J Pain Symptom Manage · Sep 2019
Validation of the Chinese version of the Good Death Inventory for evaluating end-of-life care from the perspective of the bereaved family.
It is essential to evaluate good death of patients with cancer. However, currently, there is no validated measurement tool available in Mainland China. ⋯ The psychometric characteristics of the Chinese version of the GDI indicate that this questionnaire is reliable and valid. It can be used as a tool for the assessment of quality of death and dying of patients with cancer among the Chinese population.
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As our population ages, there will be an increasing number of patients with life-limiting disease who may be referred for major elective surgery and more pressingly may present acutely, requiring major emergency surgical intervention. Owing to the high risk of perioperative and postoperative complications associated this group of patients, it is paramount that specific advance care planning that encompasses a patient's goals of care and resuscitative status be clarified before undergoing surgery in this acute period. ⋯ Furthermore, it will help to prevent futile and inappropriate treatments that do not respect a patient's wishes and their clinical status. In this case discussion, we explore the key themes about the challenge of perioperative advance care planning for patients with life-limiting disease and provide a framework to help guide conversation in this crucial period.
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J Pain Symptom Manage · Sep 2019
Randomized Controlled Trial Multicenter StudyAssociation between Plasma Brain Natriuretic Peptide and Overall Survival in Patients with Advanced Cancer: Preliminary Findings.
Atrial and brain natriuretic peptides (ANP and BNP) are established diagnostic and prognostic markers in heart failure, but their utility in patients with advanced cancer is unclear. ⋯ Our preliminary findings suggest that BNP or Pro-BNP may be a novel objective prognostic marker in cancer patients without heart failure. Further research is needed to confirm these findings.
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J Pain Symptom Manage · Sep 2019
Randomized Controlled TrialTo what extent do the NRS and CRQ capture change in patients' experience of breathlessness in advanced disease? Findings from a mixed-methods double blind randomised feasibility trial.
Chronic or refractory breathlessness is common and distressing. To evaluate new treatments, outcome measures that capture change in patients' experience are needed. ⋯ This study found that the NRS using the question "How bad has your breathlessness felt at its worst over the past 24 hours?" captured change across multiple domains, and therefore may be an appropriate primary outcome measure in trials in this population. Future work should confirm the construct validity of this question.