Publication Language: English

Patterns of high-dose morphine use in a home-care hospice service: should we be afraid of it?

Background: Management of cancer pain is one of the most important goals of palliative care. Relieving pain is often problematic. High doses of morphine at home may be required to relieve patients’ pain, and is therefore feared. The goals of the current study were to assess the feasibility of high-dose morphine use at home, to characterize …

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Multidimensional continuous pain assessment chart (MCPAC) for terminal cancer patients: a preliminary report

Current use of pain measures is limited in clinical practice. The common pain measures neither target nor monitor the changes that occur with time with regard to the effect of other parameters associated with pain control. Changes in parameters, such as pain type, various pharmacological and nonpharmacological interventions, dosage of medications, and use of rescue …

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A multicentre international study of sedation for uncontrolled symptoms in terminally ill patients

The issue of symptom management at the end of life and the need to use sedation has become a controversial topic. This debate has been intensified by the suggestion that sedation may correlate with ‘slow euthanasia’. The need to have more facts and less anecdote was a motivating factor in this multicentre study. Four palliative …

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Salivary flow and its relation with oral symptoms in terminally ill patients

Background: Patients with terminal malignant disease commonly report hyposalivation or xerostomia. This leads to “dry mouth,” fungal infection, and mucosal abnormalities. To the authors’ knowledge oral symptomatology and findings have not been correlated previously with accurate salivary flow measurements. Methods: Measurement of stimulated parotid salivary flow rate and clinical recording of oral symptoms within 24 hours from …

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High dose morphine use in the hospice setting. A database survey of patient characteristics and effect on life expectancy

Background: Pain control is one of the most important goals of end-of-life care, and the use of opioids for this purpose is extremely common in hospice settings. However, it is unknown how many of the patients require high dose morphine (HDM, >299 mg/day of oral morphine equivalent), what the characteristics of these patients are, and whether …

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Home and inpatient hospice care of terminal head and neck cancer patients

The objective is to evaluate and compare data on a cohort of terminal head and neck cancer (HNC) patients from both home and hospital-based hospice programs and to define the particular problems and needs of those patients. The setting was a tertiary academic referral centre in Tel Hashomer, Israel. We carried out a retrospective survey …

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Corticosteroids in terminal cancer

Corticosteroids are frequently prescribed in terminal cancer. They were prescribed in more than 50% of 100 consecutive patients of our hospice for palliation of anorexia, weakness, symptoms of cerebral metastases and of hypercalcemia, and other problems. There was objective and/or subjective improvement in most, though usually of short duration. If there is no improvement after …

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