Abstract：
:Delirium often causes severe distress for terminally ill cancer patients, and treatment of underlying pathologies is important to achieve symptom alleviation. Although accumulation of morphine metabolites may play an important role in development of delirium, empirical findings are conflicting due to a large inter-individual variation in morphine-related concentrations. To explore intra-individual changes of morphine metabolite concentrations before and after occurrence of terminal delirium, a prospective observational study was performed on terminally ill cancer patients. Among 131 consecutive hospice inpatients, 16 samples from 8 patients who received two blood samplings before and after development of delirium were analyzed. Delirium developed a median of 5 days before death, and clinical causes were attributed to multi-organ failure. Plasma concentrations of morphine-6-glucuronide (M-6-G) and morphine-3-glucuronide (M-3-G) significantly increased after development of delirium within the same patient. Mean normalized concentrations of M-6-G and M-3-G elevated from 1.24 +/- 1.06 to 2.94 +/- 3.52 ng/mL/mg (P = 0.016), and from 7.46 +/- 4.75 to 15.4 +/- 13.2 ng/mL/mg (P = 0.016), respectively. Normalized morphine concentration increased with a marginal statistical significance from 0.54 +/- 0.27 to 0.83 +/- 0.22 ng/mL/mg (P = 0.055). In conclusion, plasma concentrations of M-6-G and M-3-G were significantly higher after development of terminal delirium than before. It is suggested that accumulations of morphine metabolites can contribute to development of delirium in cancer patients whose death is impending.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Morita T,Tei Y,Tsunoda J,Inoue S,Chihara Sdoi
10.1016/s0885-3924(01)00392-xsubject
Has Abstractpub_date
2002-02-01 00:00:00pages
107-13issue
2eissn
0885-3924issn
1873-6513pii
S088539240100392Xjournal_volume
23pub_type
杂志文章abstract：CONTEXT:Documenting patients' advance care planning (ACP) wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about ACP documentation practices in the electronic health record. OBJECTIVES:The objective of this study was to describe ACP documentation ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.09.018
更新日期：2018-02-01 00:00:00
abstract：:The authors report the data from two studies on the use of controlled-release morphine sulphate tablets for cancer pain relief. This preparation allows just two administrations per day, in comparison with immediate release oral aqueous morphine solution. The first study, a randomized trial carried out on 70 patients s...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0885-3924(89)90005-5
更新日期：1989-09-01 00:00:00
abstract：:Octreotide, a synthetic analogue of the hormone somatostatin, is primarily used in palliative medicine because of its antisecretory effect and has been shown to be effective in the management of bowel obstruction, nausea, and diarrhea. Octreotide also has been successfully used for the management of bronchorrhea in bo...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2013.06.008
更新日期：2014-04-01 00:00:00
abstract：CONTEXT:Emergency physicians (EPs) often need to make a decision whether or not to intubate a terminal cancer patient. OBJECTIVE:The objective of this study was to explore EPs' attitudes about intubating critically ill, terminal cancer patients. METHODS:Fifty EPs at three emergency departments (one university based, ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.07.038
更新日期：2017-11-01 00:00:00
abstract：:To delineate dose ranges, utilization patterns, and the frequency and types of problems encountered, we retrospectively reviewed the medical records of 46 patients with sickle hemoglobinopathies who used patient-controlled analgesia (PCA) a total of 92 times for the management of vasooclusive pain. Patients varied wid...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/0885-3924(93)90116-d
更新日期：1993-01-01 00:00:00
abstract：CONTEXT:Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm. OBJECTIVES:This study aims to improve identification of patients who would benefit from palliative care services, and calculate palliative care penetration rates. METHODS:This s...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.09.013
更新日期：2018-02-01 00:00:00
abstract：CONTEXT:Multiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents. OBJECTIVES:We investigated whether parents practiced safe storage, use, and disposal techniques of op...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.09.018
更新日期：2020-02-01 00:00:00
abstract：:There is little objective data on how cancer and its therapy affect physical activity. The main aims of this pilot study were 1) to compare physical activity in patients receiving palliative chemotherapy and healthy controls, and 2) to explore the relationship between patients' activity, quality of life (QoL), and cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2006.09.024
更新日期：2007-06-01 00:00:00
abstract：CONTEXT:Efforts in developing useful tools to properly identify the end-of-life trajectory of patients with advanced medical diseases have been made, but the calibration and/or discriminative power of these tools has not been optimal. OBJECTIVES:Our objective was to develop a new, reliable prognostic tool to identify ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2013.04.011
更新日期：2014-03-01 00:00:00
abstract：:Conducting palliative care research can be personally and professionally challenging. Although limitations in funding and training opportunities are well described, a less recognized barrier to successful palliative care research is creating a sustainable and resilient team. In this special report, we describe the exp...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.06.033
更新日期：2020-10-01 00:00:00
abstract：CONTEXT:Limited information is available about lung cancer patients' symptoms in the pre- and postoperative periods. OBJECTIVES:Study purposes were to evaluate for changes in symptom occurrence and severity from the preoperative period to five months after surgery and to evaluate for predictors of the occurrence and t...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.11.297
更新日期：2015-06-01 00:00:00
abstract：:We explored the effect of intravenous infusions of a bisphosphonate, pamidronate, in the management of chronic mechanical spinal pain, a worldwide public health problem in terms of lost workdays, medical treatment costs, and suffering. Bisphosphonates have an anti-nociceptive effect in animals. In humans, intravenous ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(03)00201-x
更新日期：2003-07-01 00:00:00
abstract：:Within aging European populations, the need to progress end-of-life and palliative care policy is becoming increasingly important. PRISMA, a European Commission-funded project, aimed to identify and coordinate research priorities, measurement, and practice in end-of-life care for Europe. PRISMA conducted a three-year ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.06.006
更新日期：2011-10-01 00:00:00
abstract：CONTEXT:To date, there is no study comparing palliative care (PC) development among African countries. OBJECTIVES:To analyze comparatively PC development in African countries based on region-specific indicators. METHODS:Data were obtained from the African PC Association Atlas of PC in Africa, and a comparative analys...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.05.005
更新日期：2018-08-01 00:00:00
abstract：CONTEXT:The use of unidimensional pain scales such as the Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), or Visual Analogue Scale (VAS) is recommended for assessment of pain intensity (PI). A literature review of studies specifically comparing the NRS, VRS, and/or VAS for unidimensional self-report of PI was ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2010.08.016
更新日期：2011-06-01 00:00:00
abstract：:We report on the adaptation and evaluation of a previously developed patient-centered instrument that we call the Quality of End-of-life care and Satisfaction with Treatment (QUEST) scale. In a separate group of 30 inpatients, test-retest reliability for QUEST items ranged from 63% agreement (kappa = 0.43) to 93% agre...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/s0885-3924(02)00409-8
更新日期：2002-06-01 00:00:00
abstract：CONTEXT:Cancer patients with cachexia may suffer from significant burden of symptoms and it can severely impair patients' quality of life. However, only few studies have targeted the symptom burden in cancer cachexia patients, and whether the symptom burden differed in different cachexia stages is still unclear. OBJEC...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2016.12.325
更新日期：2017-05-01 00:00:00
abstract：CONTEXT:Burdensome symptoms present frequently in dementia at the end of life, but we know little about the symptom control provided, such as type and dosage of medication. OBJECTIVES:To investigate symptom prevalence and prescribed treatment, explore associations with quality of life (QOL) in the last week of life, a...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2013.05.015
更新日期：2014-04-01 00:00:00
abstract：CONTEXT:Fatigue is highly prevalent in populations with advanced illness and is often associated with depressed mood. The role of psychostimulant therapy in the treatment of these conditions remains ill defined. OBJECTIVES:To evaluate the response of fatigue and depression in patients with advanced illness to titrated...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpainsymman.2011.03.026
更新日期：2012-01-01 00:00:00
abstract：:Continuing the transition to competency-based education, Hospice and Palliative Medicine (HPM) fellowship programs began using context-free reporting milestones (RMs) for internal medicine subspecialties in 2014 but quickly recognized that they did not reflect the nuanced practice of the field. This article describes ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.01.008
更新日期：2020-07-01 00:00:00
abstract：CONTEXT:General practitioners (GPs) and community nurses (CNs) have a central role in palliative care. With health policy focusing more and more on enabling patients to die at home, primary health care professionals are increasingly responsible for symptom management of patients near the end of life. OBJECTIVES:1) To ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2012.09.004
更新日期：2013-09-01 00:00:00
abstract：:The European Organization for Research and Treatment of Cancer colorectal cancer (CRC)-specific quality-of-life questionnaire module (QLQ-CR38) assesses health-related quality of life in patients with CRC. We studied its psychometric properties and clinical validity in Hong Kong Chinese patients with CRC. The 38 items...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2007.03.013
更新日期：2008-02-01 00:00:00
abstract：CONTEXT:Older and seriously ill Australians are often admitted to hospital in the last year of their life. The extent to which these individuals have considered important aspects of end-of-life (EOL) care, including location in which care is provided, goals of care, and involvement of others in decision making, is uncl...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.09.003
更新日期：2020-02-01 00:00:00
abstract：CONTEXT:Many breast cancer patients have unmet informational and psychosocial needs after treatment completion. A psychoeducational intervention may be well suited to support these patients. OBJECTIVES:The purpose of this multicenter randomized controlled trial was to examine the effectiveness of a web-based tailored ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jpainsymman.2017.07.009
更新日期：2017-10-01 00:00:00
abstract：CONTEXT:Although episodic breathlessness (EB) is reported to be highly prevalent in advanced disease, our understanding about it is limited. OBJECTIVES:The aim of this study was to systematically review and synthesize the evidence on EB regarding definition, characteristics, and patients' experiences. METHODS:Systema...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpainsymman.2012.02.022
更新日期：2013-03-01 00:00:00
abstract：CONTEXT:Palliative radiotherapy is effective in the management of symptoms resulting from advanced cancer. However, it remains underutilized. In developed countries, many factors have been linked to this phenomenon but data in developing and low-income countries, particularly in Latin America, are lacking. OBJECTIVES:...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.06.021
更新日期：2020-12-01 00:00:00
abstract：CONTEXT:Research, guidelines, and experts in the field suggest that persons with cognitive impairment report pain less often and at a lower intensity than those without cognitive impairment. However, this presupposition is derived from research with important limitations, namely, inadequate power and lack of multivaria...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2009.09.016
更新日期：2010-04-01 00:00:00
abstract：:This study examined the relationship between patient and partner ratings of self-efficacy for symptom control and quality of life (QOL) among 40 African American prostate cancer survivors and their intimate partners. Data analyses revealed that cancer survivors who had rated their self-efficacy for symptom control hig...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2004.02.020
更新日期：2004-11-01 00:00:00
abstract：:The relationships between plasma morphine and metabolite (M3G and M6G) concentrations and analgesic efficacy were investigated in an open study of 39 cancer pain patients receiving chronic oral morphine therapy with either morphine sulfate solution or controlled-release morphine tablets. There were no differences in m...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
doi：10.1016/0885-3924(95)00148-4
更新日期：1996-02-01 00:00:00
abstract：CONTEXT:Symptom management is essential in the end-of-life care of long-term care facility residents. OBJECTIVES:To study discrepancies and possible associated factors in staff and family carers' symptom assessment scores for residents in the last week of life. METHODS:A postmortem survey in Belgium, The Netherlands,...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.03.002
更新日期：2020-08-01 00:00:00
