Abstract:
BACKGROUND:Bisphosphonates are the treatment of choice for hypercalcaemia of malignancy (HCM) but there is no consensus regarding which drug or dose should be given. We designed a systematic review to investigate the efficacy of bisphosphonates in the treatment of HCM. METHODS:We identified randomized controlled trials (RCTs) by searching electronic databases, scanning of reference lists, and consultation with experts and pharmaceutical companies. Foreign papers were translated. Inclusion criteria were RCTs, confirmed malignant disease and measurement of serum calcium (ionized or corrected for albumin) postrehydration. The primary outcome was number of patients achieving normocalcaemia. Secondary outcomes were time to normocalcaemia, time to relapse and toxicity. RESULTS:Twenty-seven papers and two abstracts, using intravenous bisphosphonates, fulfilled the inclusion criteria. Data from 26 studies were used in analyses. Due to the heterogeneity of studies, meta-analysis could not be performed. Pamidronate was more effective than placebo, mithramycin, etidronate (7.5 mg/kg) and low-dose clodronate (600 mg), but equal to higher dose clodronate (1500 mg). Clodronate and etidronate were superior to placebo; incadronate was superior to elcatonin; gallium nitrate was superior to etidronate. No difference was seen between alendronate and clodronate. Three dose finding studies showed no difference between 30-90 mg of pamidronate, but one well designed study showed increasing efficacy with increasing dose. Studies using increasing doses of ibandronate (0.6-4 mg), alendronate (2.5-15 mg), and incadronate (2.5-10mg), showed a dose response. Duration of administration of pamidronate did not affect efficacy (six studies). CONCLUSION:Bisphosphonates normalize calcium in >70% patients with minimal side effects. Aminobisphosphonates are most effective at maintaining normocalcaemia and should be given in high dose irrespective of baseline serum calcium.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Saunders Y,Ross JR,Broadley KE,Edmonds PM,Patel S,Steering Group.doi
10.1191/0269216304pm914rasubject
Has Abstractpub_date
2004-07-01 00:00:00pages
418-31issue
5eissn
0269-2163issn
1477-030Xjournal_volume
18pub_type
杂志文章,评审abstract:BACKGROUND:Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care. AIM:To review and appraise the existing evidence abo...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319862160
更新日期:2019-12-01 00:00:00
abstract:PURPOSE/OBJECTIVE:Patients with cancer or symptoms referable to cancer therapy were offered acupuncture as potential palliation of their symptoms. This paper describes the physical integration of the discipline into the Oncology Clinic, and patient perspectives on its availability and efficacy. PATIENTS AND METHODS:Be...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216302pm540oa
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Constipation affects many patients receiving long-term opioid therapy for cancer pain. Little is known about the nature of psychological distress and the burden associated with this problem. This information may inform the development of effective treatment strategies and ameliorate distress. AIM:The object...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216312450358
更新日期:2013-05-01 00:00:00
abstract::It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921601678576176
更新日期:2001-05-01 00:00:00
abstract::This is a review of tools that have been developed to assess pain in children, with a brief evaluation of their practicality and validity. There are some suggestions for the direction of future research in the development and use of the scales. ...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639701100503
更新日期:1997-09-01 00:00:00
abstract::Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216307081940
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. AIM:This study aimed to translate, ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311419987
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The Delirium Observation Screening Scale (DOS) is designed to detect delirium by nurses' observations and has shown good psychometric properties. Its use in palliative care unit patients has not been studied. AIM:To determine diagnostic and concurrent validity, internal consistency, and user-friendliness of...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313492187
更新日期:2014-01-01 00:00:00
abstract:STUDY OBJECTIVE:The Italian Survey of the Dying of Cancer (ISDOC) was undertaken to evaluate the experiences of Italian people dying from cancer during their last three months of life in all settings of care. STUDY DESIGN:A two-stage probability sample was used to estimate end-of-life outcomes of about 160 000 Italian...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1086oa
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase. AIM:To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual mod...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319840275
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. AIM:To examine associations among implantable cardioverter defibrillator knowledge, pa...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216317718438
更新日期:2018-01-01 00:00:00
abstract::We investigated the impact of perception of socioeconomic burden on beliefs regarding a patient's autonomy in end-of-life (EOL) decision making. We also sought to identify the characteristics of individuals who advocate patient autonomy and their attitudes toward other EOL issues. A total of 1055 individuals from the ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216308099244
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Palliative medicine is not recognized as a medical specialty in any of the five Nordic countries, but there is a great need for physicians with specialty qualifications to serve on an increasing number of palliative care services. The Associations for Palliative Medicine in the five countries agreed...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216307087320
更新日期:2008-04-01 00:00:00
abstract::Chronic cough is a distressing symptom experienced by approximately 37% of patients with advanced cancer. Palliation of chronic nonproductive cough should always first address the underlying cause but in some patients chronic, nonproductive cough persists and antitussive agents are required. Opioids are the gold stand...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921698672930910
更新日期:1998-01-01 00:00:00
abstract::This paper presents a qualitative study exploring the meaning of 'dignity' to patients, relatives and professionals. It examines the impact of advanced illness and treatment and the issues pertinent to caring for dignity. Depth interviews were conducted with eight patients, six relatives and seven members of the multi...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216303pm699oa
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. AIM:To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palli...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216318764095
更新日期:2018-07-01 00:00:00
abstract::The McGill Quality of Life Questionnaire (MQOL) is a widely used tool that has been specifically developed to measure the quality of life of patients facing a life-threatening illness. Preferably, a self-report instrument has an equal number of items worded positively and negatively. However, all the psychological sca...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216308094519
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. AIM:(1) To as...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313483185
更新日期:2013-07-01 00:00:00
abstract::This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associa...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/026921639701100405
更新日期:1997-07-01 00:00:00
abstract::The high prevalence of pain and other symptoms throughout the HIV disease trajectory, the need for management of side effects related to antiretroviral therapy, the continuing incidence of cancers and new emerging co-morbidities as a result of extended life expectancy under new therapeutic regimes, and the ongoing nee...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1191/0269216305pm1005oa
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:People with dementia requiring palliative care have multiple needs, which are amplified in long-term care settings. The European Association for Palliative Care White Paper offers recommendations for optimal palliative care in dementia integral for this population, providing useful guidance to inform interve...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319900141
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:We developed a new single point of access to integrated palliative care, respiratory medicine and physiotherapy: the breathlessness support service for patients with advanced disease and refractory breathlessness. This study aimed to describe patients' experiences of the service and identify the aspects valu...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216315600103
更新日期:2016-03-01 00:00:00
abstract::Existential distress has been recognized as a source of suffering for oncology patients. This study focusses on existential issues and coping mechanisms of a unique culturally diverse Jewish/Middle Eastern oncology population. A qualitative assessment of 40 patients with advanced cancer was undertaken through an inter...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/0269216305pm1038oa
更新日期:2005-07-01 00:00:00
abstract::Homeless persons tend to die younger than the housed population and have complex, often unmet, end-of-life care needs. High levels of illicit drug use among this population are a particular challenge for health and social services professionals involved in end-of-life care services delivery. This article explores the ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311402713
更新日期:2012-06-01 00:00:00
abstract::Enabling patients to be cared for in their preferred location often involves journeys between care settings. The challenge of ensuring journeys are timely and safe emerged as an important issue in an evaluation of palliative care services, which informed a service redesign programme in three areas of the United Kingdo...
journal_title:Palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0269216309106893
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:It is often suggested that terminally ill patients favour end-of-life care at home. Yet, it is unclear how these preferences are formed, if the process is similar for patients and family caregivers, and if there are discrepancies between preferences for place of care and place of death. Understanding these n...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216319845794
更新日期:2019-07-01 00:00:00
abstract::The frequency of the use of laxatives, and the relationship between doses of laxatives and of opioid analgesia, were determined by a prospective study of 498 hospice inpatients with advanced cancer. Laxatives were required by 87% of patients taking oral strong opioids, 74% of those on weak opioids and 64% of those not...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1191/026921698674125048
更新日期:1998-09-01 00:00:00
abstract::Patients with advanced cancer experience multiple demands and losses that place them at risk for experiencing psychological distress. Researchers can face challenges in conducting research among this population because of their poor levels of physical and cognitive functioning. This paper aims to develop our understan...
journal_title:Palliative medicine
pub_type: 杂志文章,评审
doi:10.1177/0269216311399663
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:the right for patients of all diagnoses to be in receipt of palliative care from an early point in the diagnosis of a life-limiting condition is now enshrined in policy in a number of countries and increased emphasis is placed upon the role of generalist palliative care. However, little is known as to how th...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216311408993
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:While there have been some studies looking at the impact on quality of life of patients with idiopathic pulmonary fibrosis, to date no qualitative research looking at the specialist palliative needs of these patients has been conducted. AIM:This study aims to explore the specialist palliative care needs of ...
journal_title:Palliative medicine
pub_type: 杂志文章
doi:10.1177/0269216313497226
更新日期:2013-10-01 00:00:00