Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2021
Acupuncture as an adjunctive treatment for pain in hospitalized children with sickle cell disease.
Acute episodes of pain associated with sickle cell disease (SCD) account for over 100,000 hospitalizations and expenses of nearly one billion dollars annually in the U.S. New treatment approaches are needed as the current opioid based therapy is often inadequate in controlling pain, resulting in prolonged inpatient stays, and high rates of readmission. ⋯ Acupuncture was broadly accepted and well-tolerated in our study population. Acupuncture treatment was associated with a statistically significant and clinically meaningful reduction in pain scores immediately following the treatments, and a trend towards a reduction in length of stay and readmission for pain.
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J Pain Symptom Manage · Dec 2021
Randomized Controlled TrialMirtazapine in cancer-associated anorexia and cachexia: A double-blind placebo-controlled randomized trial.
Few pharmacological interventions are available for cancer-associated anorexia and cachexia. Mirtazapine has been suggested for use in cancer-associated anorexia and cachexia. ⋯ Mirtazapine 15mg at night for 28 days is no better than placebo in improving the appetite of incurable solid tumor patients with cancer-associated anorexia and cachexia.
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J Pain Symptom Manage · Dec 2021
Requests for Accommodation in Brain Death Cases: Emerging Role for Pediatric Palliative Care.
Death by neurologic criteria is a diagnosis that has presented complexities since its inception and pediatric cases are no exception. While rare, families may request accommodation to deviate from the traditionally defined diagnostic pathway based on their beliefs, mistrust of the diagnosis, or other complex reasons. ⋯ Common themes in many of these cases are trauma, bias and their impact on caregivers. We use a case-based approach to explore these complexities and clinical tools.