A difficult clinical problem: Diagnosis, impact and clinical management of cachexia in palliative care

2009 ◽  
Vol 15 (7) ◽  
pp. 320-326 ◽  
Author(s):  
Susan Holmes
Keyword(s):  
Palliative Care ◽  
Clinical Management ◽  
Clinical Problem ◽  
Problem Diagnosis

scholarly journals Molecular Mechanisms Underlying Remodeling of Ductus Arteriosus: Looking beyond the Prostaglandin Pathway

2021 ◽  
Vol 22 (6) ◽  
pp. 3238
Author(s):  
Ho-Wei Hsu ◽  
Ting-Yi Lin ◽  
Yi-Ching Liu ◽  
Jwu-Lai Yeh ◽  
Jong-Hau Hsu
Keyword(s):  
Adverse Effect ◽  
Clinical Management ◽  
Vascular Remodeling ◽  
Molecular Mechanisms ◽  
Surgical Intervention ◽  
Ductus Arteriosus ◽  
Clinical Problem ◽  
Cyclooxygenase Inhibitors ◽  
Medical Patients ◽  
Fetal Circulation

The ductus arteriosus (DA) is a physiologic vessel crucial for fetal circulation. As a major regulating factor, the prostaglandin pathway has long been the target for DA patency maintenance or closure. However, the adverse effect of prostaglandins and their inhibitors has been a major unsolved clinical problem. Furthermore, a significant portion of patients with patent DA fail to respond to cyclooxygenase inhibitors that target the prostaglandin pathway. These unresponsive medical patients ultimately require surgical intervention and highlight the importance of exploring pathways independent from this well-recognized prostaglandin pathway. The clinical limitations of prostaglandin-targeting therapeutics prompted us to investigate molecules beyond the prostaglandin pathway. Thus, this article introduces molecules independent from the prostaglandin pathway based on their correlating mechanisms contributing to vascular remodeling. These molecules may serve as potential targets for future DA patency clinical management.

scholarly journals The potential of palliative care for patients with respiratory diseases

Breathe ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 278-289 ◽  
Author(s):  
Georgia L. Narsavage ◽  
Yea-Jyh Chen ◽  
Bettina Korn ◽  
Ronit Elk
Keyword(s):  
Palliative Care ◽  
Clinical Management ◽  
Respiratory Diseases ◽  
Life Quality ◽  
List Type ◽  
Educational Aims ◽  
Chronic Respiratory Diseases ◽  
Disease Trajectory ◽  
Sputum Production ◽  
Respiratory Conditions

Based on the demonstrated effectiveness of palliative care in the alleviation of symptoms and enhancement of life quality, it is important to incorporate palliative care early in the respiratory disease trajectory. Quality palliative care addresses eight domains that are all patient and family centred. Palliative care interventions in respiratory conditions include management of symptoms such as dyspnoea, cough, haemoptysis, sputum production, fatigue and respiratory secretion management, especially as the end-of-life nears. A practical checklist of activities based on the domains of palliative care can assist clinicians to integrate palliative care into their practice. Clinical management of patients receiving palliative care requires consideration of human factors and related organisational characteristics that involve cultural, educational and motivational aspects of the patient/family and clinicians.Educational aimsTo explain the basic domains of palliative care applicable to chronic respiratory diseases.To review palliative care interventions for patients with chronic respiratory diseases.To outline a checklist for clinicians to use in practice, based on the domains of palliative care.To propose recommendations for clinical management of patients receiving palliative care for chronic respiratory diseases.

Mentoring initiative to retain community-based registered nurses in palliative care

2020 ◽  
Vol 25 (7) ◽  
pp. 335-339
Author(s):  
Siobhan Johnston ◽  
Paula Heneghan ◽  
Pauline Daniels
Keyword(s):  
Palliative Care ◽  
Registered Nurses ◽  
Clinical Management ◽  
Peer Mentoring ◽  
First Year ◽  
Marie Curie ◽  
Home Nursing ◽  
Community Based ◽  
Nursing Service ◽  
Key Stakeholders

Retaining registered nurses (RNs) in post during their first year of employment is a problem for the Marie Curie Home Nursing Service. This article describes an initiative undertaken by Marie Curie Northern Ireland's (NI) Regional Nursing Service's manager in conjunction with clinical management and RNs to develop a peer-mentoring programme that would support newly appointed RNs during their first 3 months and strengthen the possibility that they would remain in post. A scoping exercise of key stakeholders clarified that peer mentoring could address the sense of remoteness and isolation that newly appointed nurses expressed as lone workers. RNs taking on a peer-mentoring role received additional remuneration during the 3-month period. Through the initiative, the stakeholders recognised that the peer-mentoring programme should be simple, responsive to the needs of the newly appointed nurses and provide the necessary support and guidance when required.

scholarly journals Do the clinical management guidelines for Covid-19 in African Countries reflect the African quality palliative care standards? A rapid review.

2020 ◽  
Author(s):  
Oladayo A Afolabi ◽  
Mary Abboah-Offei ◽  
Eve Namisango ◽  
Emeka Chukwusa ◽  
Adejoke O. Oluyase ◽  
...  
Keyword(s):  
Palliative Care ◽  
Clinical Management ◽  
Rapid Review ◽  
African Countries ◽  
Management Guidelines

Cellular phone-based application as a tool in pediatric palliative care.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 48-48
Author(s):  
MarÃa Sabina Ah Chu Sánchez
Keyword(s):  
Palliative Care ◽  
Instant Messaging ◽  
Care Center ◽  
Clinical Problem ◽  
Pediatric Palliative Care ◽  
Care Group ◽  
Specific Information ◽  
Health Care Center ◽  
Community Team ◽  
Naval Force

48 Background: Free cross-platform instant messaging is a popular way of communicating in Panama. Is it possible to apply this in Palliative Care (PC)? Methods: This is a descriptive transversal study of some problems we could solve internally with the help of this cell phone-based application. The universe is the total of consultations of the PC Pediatric Support Team in Panamá Children’s Hospital to the National Program of PC from May 2016 to July 2018. First, we developed a chat group, so all 55 members of the national palliative program can share specific information related to PC topics. We describe the most common problems that we can solve with the help of instant messaging technology such as: 1. Presentation of cases at the time of their going-back home from the hospital-team to the community-team. 2. Presentation of urgent cases to the National Aero-Naval Force to be transported by boat or plane. 3. Education of mothers on specific problems they have at home. Results: We had 113 consultations in pediatric palliative care group. Of those, 78% had to be presented to the community-health-care-center (88 cases). The time-of-response was in the range of 5-120 minutes. We had to arrange sanitary transportation by boat or plane in 14% of the cases. Of those cases we obtained a response by the Aero-Naval force in less than 24 hours. We solved specific palliative symptom problems such as: fever, administration of the rescue dose, mucositis, and coping problems in some patients that lived more than two hours from the nearest health-center. For this we used educational videos made for this purpose. Conclusions: Instant messaging technology is used for the provision of palliative care communication, safety transportation and clinical problem solving. It had to be used in conditions that protect the privacy of patients and families. This current study suggest that this is a new opportunity that must be considered for its efficiency in solving specific problems.

Distress in palliative care patients: Developing patient-centred approaches to clinical management

2008 ◽  
Vol 44 (8) ◽  
pp. 1133-1138 ◽  
Author(s):  
Mari Lloyd-Williams ◽  
Joanne Reeve ◽  
David Kissane
Keyword(s):  
Palliative Care ◽  
Clinical Management

scholarly journals A national cross-sectional survey of constipation in patients attending cancer centres in Ireland

2021 ◽  
Vol 4 ◽  
pp. 113
Author(s):  
Karen Ryan ◽  
Bridget M. Johnston ◽  
Clare McAleer ◽  
Laserina O'Connor ◽  
Philip Larkin
Keyword(s):  
Palliative Care ◽  
Clinical Problem ◽  
Assessment Scale ◽  
Care Practice ◽  
Specialist Palliative Care ◽  
Opioid Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Laxative Use ◽  
Scale Scores

Background: The prevalence of constipation in patients with cancer is estimated at 50-90%. It is often associated with pain, anorexia, nausea and vomiting and impacts negatively on quality of life. Despite its common occurrence, it is often poorly recognised and treated by healthcare professionals. Methods: A national cross-sectional survey was conducted in Ireland to describe constipation prevalence and severity in patients attending cancer centres and to evaluate management efficacy.  In-patients or patients attending day oncology wards in any of the country’s eight designated cancer centres were eligible to participate. Participants were shown the Bristol Stool Chart  and answered questions regarding stool appearance and sensation of  incomplete defecation; they completed the Constipation Assessment Scale. Data on pain character and intensity, opioid use, and prescribed and over-the-counter laxative use were collected. Data were summarised using descriptive statistics. Significance of variations for continuous data were determined using t-tests. Conditional ordered logistic regression was undertaken to determine factors associated with constipation. Results: The dataset comprised 491 patients. 24.8% had been reviewed by specialist palliative care; 14.5% by the anaesthetic pain team. In total, 42.2% of respondents were taking step 2 or step 3 opioids. Constipation prevalence was 67.6%; 19.4% of patients had Constipation Assessment Scale scores indicating severe constipation. A total of 46% of the respondents were not taking any laxatives. Of those who were taking laxatives, 54.8%  reported constipation symptoms. While opioid use was strongly associated with participants reporting higher scores, this association was not seen in those patients receiving specialist palliative care. Conclusions: Constipation remains a clinical problem in Irish cancer centres. Despite increased opioid use, patients receiving specialist palliative care were more likely to take laxatives and reported less constipation. Specialist palliative care practice should be studied in order to identify what are the transferable ‘ingredients’ of effective constipation management.

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