Journal of palliative medicine
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Our aim was to evaluate the use of very-low-dose methadone with haloperidol in the acute-care setting. ⋯ The use of very-low-dose methadone in conjunction with haloperidol in the acute-care setting resulted in improved pain control after conversion from typical opiates.
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Comparative Study
Predictors of six-month mortality among nursing home residents: diagnoses may be more predictive than functional disability.
Loss of daily living functions can be a marker for end of life and possible hospice eligibility. Unfortunately, data on patient's functional abilities is not available in all settings. In this study we compare predictive accuracy of two indices designed to predict 6-month mortality among nursing home residents. One is based on traditional measures of functional deterioration and the other on patients' diagnoses and demography. ⋯ For nursing home residents, comorbid diagnoses predict 6-month mortality more accurately than functional status. The HELP Index can be used to estimate 6-month mortality from hospital data and can guide prognostic discussions prior to and following nursing home admission.
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Comparative Study
Consciousness levels one week after admission to a palliative care unit improve survival prediction in advanced cancer patients.
Consciousness is an important factor of survival prediction in advanced cancer patients. However, effects on survival of changes over time in consciousness in advanced cancer patients have not been fully explored. ⋯ Consciousness levels one week after admission should be integrated into survival prediction in advanced cancer patients.
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Cancer and its treatment can significantly affect appearance and body integrity. A number of studies have explored the impact of cancer and its treatment on body image, primarily in head and neck and breast cancer. The aim of this pilot study was to examine the construct of body image dissatisfaction and its measurement using a single question in patients with advanced cancer. ⋯ Body image dissatisfaction was frequent and associated with symptom burden. A single item ≤3 has a sensitivity of 70% for body image satisfaction screening.