Articles: palliative-care.
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Support Care Cancer · Jul 2000
A model of palliative care: the palliative medicine program of the Cleveland Clinic Foundation. A World Health Organization Demonstrations Project.
Patients with advanced diseases, both cancer and noncancer, experience high symptom prevalence and psychosocial distress. Multiple unmet needs in the physical, psychosocial and spiritual domains are common. In the United States, palliative medicine is an emerging discipline that focuses on meeting these needs to achieve optimal quality of life for the patient-family unit. ⋯ Over 800 new patient consultations took place in 1997. In this paper, development of the program and its structure are described. Challenges to effective communication in a large program within a tertiary care institution are discussed, and strategies designed to meet these challenges are presented.
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To calculate radiation doses of rhenium-186 ((186)Re) etidronate in painful bone metastases using quantitative bone single-photon emission computed tomography (SPECT) and to determine the threshold dose for predicting pain relief. We also wanted to determine whether technetium-99m ((99m)Tc) methylene diphosphonate (MDP) concentrations predict radiation doses of (186)Re etidronate in painful lesions. ⋯ QBS-measured radiation doses of (186)Re etidronate in painful metastases are a good predictor of pain relief. Bone SPECT using (99m)Tc MDP predicts radiation doses delivered by (186)Re etidronate.
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Support Care Cancer · Jul 2000
The impact of home palliative care on symptoms in advanced cancer patients.
Physical symptoms, which are highly prevalent in patients with cancer, have a major impact on many aspects of quality of life, and the best possible quality of life is the principal aim of palliative care. Few studies have reported the impact of home care on pain and symptoms among cancer patients living at home. The aim of this study was to evaluate the impact of home palliative care given by an experienced team on symptoms in advanced cancer patients. ⋯ Similarly, fluid and food intake significantly decreased during the last days of life. Opioid dosage and frequency of opioid use increased with time, but this change did not reach statistical significance until the last days, when 70% of patients were taking opioids. These figures demonstrate the good impact of palliative care in this group of patients.