Articles: palliative-care.
-
Randomized Controlled Trial Clinical Trial
Successful treatment of shoulder pain syndrome due to supraspinatus tendinitis with transdermal nitroglycerin. A double blind study.
We have conducted a prospective double blind randomized and placebo controlled clinical study in 20 patients with shoulder pain syndrome caused by supraspinatus tendinitis to determine whether transdermal nitroglycerin (NTG) has analgesic action in this condition. In a randomized manner we used a 5-mg NTG (Nitroplast) patch per day over 3 days or similar placebo patches applied in the most painful area. Patients were evaluated before treatment was initiated and after 24 and 48 h. ⋯ Two patients experienced headache as a side effect 24 h after treatment was started. Patients in the NTG group remained free of symptoms when they were assessed 15 days later. We conclude that NTG is useful in the treatment of shoulder pain syndrome caused by supraspinatus tendinitis and that this treatment could be a useful approach to the management of this common disturbance and probably also in other tendon musculoskeletal disorders.
-
Support Care Cancer · Jul 1996
Supportive care programs in cancer at the National Cancer Center in Tokyo.
Until recently, supportive care for cancer patients in Japan was not well organized. Not too many oncologists paid attention to the improvement of daily life of patients with advanced or terminal cancer. Oncological staffs such as doctors, nurses, psychologists, and pharmacists at hospitals in Japan did not really cooperate efficiently. ⋯ At the National Cancer Center in Japan an effort is being made to expand activities in PCU, the application of Chinese acupuncture for pain relief, and the development of a virtual reality technique. A system to connect cancer centers has been established and is now being expanded to facilitate a new database on up-to-date cancer information. We have already started holding multi-institutional medical teleconferences, telepathology and teleradiology on a weekly basis, covering nine cancer centers throughout Japan.
-
With the renaissance of interest in how best to care for patients with terminal illness comes the need to recognize palliative care and hospice programs as the completion of comprehensive cancer care, not as its antithesis. In practical terms, admission to a hospice program is appropriate when efforts to control the biologic disease have ceased to be helpful and the primary medical focus is on symptom control and quality of life. In this article, the authors explore the goals of palliative care, review the transition to a hospice program, and assess the Medicare Hospice Benefit. Furthermore, they reflect on the importance of and barriers to the appropriate adoption of palliative care programs as well as palliative care education in oncology.