Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2011
Review Meta AnalysisPsychostimulants for the management of cancer-related fatigue: a systematic review and meta-analysis.
Cancer-related fatigue (CRF) is a common and distressing symptom affecting patients with cancer. There is an increasing number of drug trials examining potential treatments for CRF. Methylphenidate represents one of the most researched drugs in this area, and an up-to-date assessment of the evidence for its use is needed. ⋯ There is preliminary evidence for the use of psychostimulants to treat CRF. The absolute numbers still remain small, and further confirmation is needed before firm recommendations on their usage and safety can be made in the treatment of CRF.
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J Pain Symptom Manage · Apr 2011
Review Meta AnalysisPalliative sedation in patients with advanced cancer followed at home: a systematic review.
Patients with advanced cancer who are near the end of life may experience intolerable suffering refractory to targeted palliative therapies. Palliative sedation (PS) is considered to be an effective treatment modality for these refractory symptoms when aggressive efforts fail to provide relief. ⋯ PS at home seems to be a feasible treatment option among selected patients and makes a potentially important contribution to improving care for those who choose to die at home. Although the existing studies provide only low-quality evidence, the decision to use PS does not seem to anticipate patients' death. More homogeneous prospective studies on a large number of patients should confirm this observation.
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J Pain Symptom Manage · Apr 2011
Review Meta AnalysisThe measurement of spirituality in palliative care and the content of tools validated cross-culturally: a systematic review.
Despite the need to assess spiritual outcomes in palliative care, little is known about the properties of the tools currently used to do so. In addition, measures of spirituality have been criticized in the literature for cultural bias, and it is unclear which tools have been validated cross-culturally. ⋯ The nine tools identified in this review are those that have currently been validated in cross-cultural palliative care populations and, subject to appraisal of their psychometric properties, may be suitable for cross-cultural research.
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J Pain Symptom Manage · Oct 2010
Review Meta AnalysisReducing the pain of nasogastric tube intubation with nebulized and atomized lidocaine: a systematic review and meta-analysis.
Nasogastric tube (NGT) intubations occur frequently in clinical practice and can be a painful procedure for patients. A systematic review of current knowledge concerning the use of nebulized lidocaine to reduce the pain of NGT insertion was conducted in order to develop evidence-based guidelines. In addition, a meta-analysis of appropriate randomized controlled trials (RCTs) was performed. ⋯ The pooled effect size was 0.423 (95% confidence interval: 0.204-0.880; Z=-2.301; P=0.021), indicating that the use of nebulized lidocaine before NGT insertion can decrease pain by 57.7%. There is insufficient evidence to recommend the dosage, concentration, or delivery method. Further research is needed to articulate a comprehensive clinical guideline.
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J Pain Symptom Manage · Jun 2010
Review Meta AnalysisA systematic review of topical treatments to control the odor of malignant fungating wounds.
Malignant fungating wounds (MFW) result from cutaneous infiltration by carcinogenic cells. Fetid odor, profuse exudate, pain, and infection are common symptoms that add to the physical and psychological suffering of patients with MFW. The topical treatment of MFW remains controversial. ⋯ Of the 59 studies of odor, 20 fulfilled all the criteria for inclusion. Few studies of high quality were found, and the principal methodological flaws were the design of the studies, the sample size, and the absence of scales to measure odor. Grade B evidence for the treatment of MFW was found with topical metronidazole, Mesalt dressing, activated carbon dressing, and curcumin ointment.