Abstract:
:Methylnaltrexone, a peripherally acting mu-opioid receptor antagonist with restricted ability to cross the blood-brain barrier, reverses opioid-induced constipation (OIC) without affecting analgesia. A double-blind study in patients with advanced illness and OIC demonstrated that methylnaltrexone significantly induced laxation within four hours after the first dose compared with placebo. In this study, patients with advanced illness and OIC on stable doses of opioids and laxatives were randomized to methylnaltrexone 0.15mg/kg (n=62) or placebo (n=71) subcutaneously every other day for two weeks. Laxation was assessed daily. Constipation distress, bowel status change, pain, laxative use, and opioid withdrawal symptoms were assessed weekly using standardized scales. Additional analyses to further characterize response to methylnaltrexone revealed that among patients with a bowel movement within four hours following the first dose, the median time to response was 0.5 hours for methylnaltrexone. Response rates among methylnaltrexone-treated patients who had responded to all previous doses were 57%-100% for doses two to seven. Among methylnaltrexone-treated patients who did not respond to the first or to the first two consecutive doses, 35% and 26% responded to the second and third dose, respectively. Higher percentages of patients and clinicians rated bowel status as improved in the methylnaltrexone than the placebo group. Fewer methylnaltrexone than placebo patients reported use of common laxative types, particularly enemas, during the study. Subcutaneous methylnaltrexone promptly and predictably induced laxation, improved constipation distress, and was associated with less laxative use in patients with advanced illness and OIC.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Chamberlain BH,Cross K,Winston JL,Thomas J,Wang W,Su C,Israel RJdoi
10.1016/j.jpainsymman.2009.02.234subject
Has Abstractpub_date
2009-11-01 00:00:00pages
683-90issue
5eissn
0885-3924issn
1873-6513pii
S0885-3924(09)00641-1journal_volume
38pub_type
杂志文章,随机对照试验abstract::The results of a randomized controlled trial that tested the effects of eight-week, six-contact multidimensional interactive interventions for symptom management are presented. Four hundred and thirty-five cancer patients with solid tumors undergoing chemotherapy were randomized to receive either nurse-assisted sympto...
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.2006.11.018
更新日期:2007-09-01 00:00:00
abstract:CONTEXT:Although previous research has, overall, suggested a moderate relationship between response expectancies (REs) and cancer treatment-related side effects, empirical results have been mixed. OBJECTIVES:We aimed to further explore these relationships, hypothesizing that REs would predict subsequent toxicities wit...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2017.03.017
更新日期:2017-08-01 00:00:00
abstract::The burden of constipation from the patient's perspective has been well described. The aim of this study was to evaluate the cost of managing constipation in patients taking opioids in a specialist palliative care inpatient unit. A retrospective review of the medical records of 58 patients (70 admissions) who died dur...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.09.007
更新日期:2010-04-01 00:00:00
abstract::Increasingly in the U.S., health care clinicians fail to recognize and accept when curative goals are no longer realistic. At this point, futile efforts at cure can fuel false hopes in patients and their loved ones. The clinician's need to be "doing something" may result in treatment that violates the dignity and well...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.07.010
更新日期:2012-10-01 00:00:00
abstract::Gabapentin was administered as an "add on" therapy to 22 patients with neuropathic cancer pain only partially responsive to opioid therapy. Global pain, burning pain, shooting pain episodes, and allodynia were assessed separately. Gabapentin was given for at least a week and efficacy was assessed after 7 to 14 days of...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/s0885-3924(99)00033-0
更新日期:1999-06-01 00:00:00
abstract::PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receivingPC-FACS, please encourage them to ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2018.01.001
更新日期:2018-03-01 00:00:00
abstract:CONTEXT:Documentation of care preferences within 48 hours of admission to an intensive care unit (ICU) is a National Quality Forum-endorsed quality metric for older adults. Care preferences are poorly captured by administrative data. OBJECTIVES:Using deep natural language processing, our aim was to determine the rate ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.12.374
更新日期:2020-06-01 00:00:00
abstract::Increasing numbers of patients with refractory pain are receiving intrathecal drug delivery systems (IDDS). We describe a case to illustrate the clinical manifestations and management implications of inadvertent overdose with drugs used in IDDS, including opioids, clonidine, baclofen, and local anesthetics. An IDDS pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2003.11.011
更新日期:2004-09-01 00:00:00
abstract::Recent empirical studies revealed that fostering patients' perception of meaning in their life is an essential task for palliative care clinicians. However, few studies have reported the effects of training programs for nurses specifically aimed at improving skills to relieve the meaninglessness of terminally ill canc...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2006.10.021
更新日期:2007-08-01 00:00:00
abstract:CONTEXT:Hospice care is traditionally used for patients with advanced cancer, but it is increasingly considered for patients with end-stage heart failure. OBJECTIVES:We compared enrollment patterns and clinical events of hospice patients with end-stage heart failure with those of patients with advanced cancer. METHOD...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.03.006
更新日期:2013-03-01 00:00:00
abstract:CONTEXT:Chronic fatigue (CF) in breast cancer (BC) survivors is multifactorial and may be caused by immune activation triggered by BC or its treatment. In the Neoadjuvant Avastin in Breast Cancer study, BC patients received neoadjuvant chemotherapy (FEC100→taxane) ± bevacizumab, a monoclonal antibody with fatigue as a ...
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.2016.09.011
更新日期:2017-03-01 00:00:00
abstract:CONTEXT:Nursing home (NH) residents with advanced dementia are commonly suspected of having infections. Most episodes are treated with antimicrobials, although evidence supporting bacterial infections is often lacking. The extent to which other interventions are used in managing suspected infections is unknown. OBJECT...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.06.011
更新日期:2015-12-01 00:00:00
abstract:CONTEXT:Three important causes of death in the U.S. (cancer, congestive heart failure, and chronic obstructive pulmonary disease) are preceded by long periods of declining health; often, family members provide most care for individuals who are living with serious illnesses and are at risk for impaired well-being. OBJE...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.09.018
更新日期:2012-09-01 00:00:00
abstract::More than 2200 subjects were enrolled in the MorphiDex (MS:DM) development program, with a 1:1 (weight:weight) ratio of morphine sulfate (MS) to dextromethorphan hydrobromide (DM). Of the 1400 subjects exposed to MorphiDex, more than 350 subjects were treated for at least 6 months, and over 200 subjects were treated f...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析
doi:10.1016/s0885-3924(99)00131-1
更新日期:2000-01-01 00:00:00
abstract::Children's pain is undertreated worldwide. Using a model of pediatric cancer pain management in Amman, Jordan, the authors demonstrated that an action research approach to pain service development resulted in a sustainable program of pain control. Barriers to care were due more often to health professionals' misconcep...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.05.006
更新日期:2008-04-01 00:00:00
abstract:CONTEXT:Chinese medicine modalities, including acupuncture and Chinese herbal medicine (CHM), have been used as palliative interventions among cancer patients. More research should be conducted to confirm their effectiveness. OBJECTIVES:The objective of this study was to prioritize Chinese medicine clinical research q...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.08.002
更新日期:2019-12-01 00:00:00
abstract::Clinical trials of investigational therapy in patients with advanced cancer may not pay sufficient attention to quality of life (QOL) and supportive care issues, resulting in an adverse impact on the quality of care (QOC). We hypothesized that the simultaneous delivery of investigational therapy and a structured progr...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2004.03.002
更新日期:2004-12-01 00:00:00
abstract:CONTEXT:Over the history of palliative care provision in Ireland, services have predominantly provided care to those with cancer. Previous estimates of palliative care need focused primarily on specialist palliative care and included only a limited number of nonmalignant diseases. OBJECTIVES:The primary aim of this st...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.09.011
更新日期:2015-04-01 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::The problem of undertreatment of acute postoperative pain has been documented in many studies. This article reviews this evidence and defines the problem of undertreatment as a group of attitudes about pain treatment that originate with deficiencies in knowledge and skills and lead to the development of inappropriate ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:
更新日期:1990-02-01 00:00:00
abstract::The European Association for Palliative Care guidelines for treatment of cancer pain recommend a double dose (DD) of immediate-release morphine at bedtime instead of single doses (SD) repeated every four hours throughout the night. A previous open controlled study reported more side effects after DD than after SD. The...
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.2007.12.016
更新日期:2009-01-01 00:00:00
abstract::Few studies have evaluated sex differences in the prevalence, severity, and correlates of fatigue at the end of life. The Brief Fatigue Inventory, McGill Quality of Life (MQOL) Questionnaire, and Karnofsky Performance Scale were administered at two-week intervals to 102 patients in a home palliative program. Outcomes ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2006.09.019
更新日期:2007-04-01 00:00:00
abstract:CONTEXT:The best evidence suggests that feeding tubes are ineffective in persons with advanced dementia. Little is known about their health care costs. OBJECTIVES:To estimate Medicare costs attributable to inpatient care among nursing home (NH) residents with advanced dementia during the year following the placement o...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.08.007
更新日期:2014-06-01 00:00:00
abstract::Cancer patients requiring strong opioid analgesia (n = 202; mean age, 61.5 years; range, 18-89 years; 55% men) were recruited from 38 United Kingdom palliative care centers into a randomized, open, two-period, crossover study comparing transdermal fentanyl with sustained-release oral morphine. Patients received one tr...
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/s0885-3924(97)00082-1
更新日期:1997-05-01 00:00:00
abstract:CONTEXT:More people are surviving into old age, and chronic diseases tend to become more common with age. Ill health and disability can lead to concerns about loss of personal dignity. OBJECTIVES:To investigate whether health status affects the perceptions of factors influencing personal dignity at the end of life, an...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.06.012
更新日期:2013-06-01 00:00:00
abstract:CONTEXT:The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure commonly used to screen for symptoms of anxiety and depression in cancer patients. The HADS has demonstrated validity in over 100 languages, including Spanish. However, validation studies have largely used European Spanish-speaking ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.05.003
更新日期:2019-08-01 00:00:00
abstract::Despite decades of research, national mandates, and widespread implementation of guidelines, recent reports suggest that the quality of pain assessment and management in hospitalized children remains suboptimal. The mismatch between what is advocated and what is done in practice has led experts to argue for a conceptu...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2011.09.005
更新日期:2012-09-01 00:00:00
abstract::Latin America consumes less than 2.7% of the morphine in the world, as reported by the governments to the International Narcotics Control Board. Methods to improve access to opioids for the treatment of pain have been developed by the Pain & Policy Studies Group (PPSG), a World Health Organization Collaborating Center...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.03.007
更新日期:2009-11-01 00:00:00
abstract:CONTEXT:Fatigue and depression are two prominent concerns in patients on in-hospital hemodialysis (IHHD) that have recently been identified as research priorities in the nephrology community. Although they are often reported to co-exist, no synthesis of the literature examining their relationship is available. OBJECTI...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2016.10.365
更新日期:2017-04-01 00:00:00
abstract:CONTEXT:Chronic pain increases with age, and in the elderly, comorbidities and polypharmacotherapy make the choice of treatment for pharmacological pain control a complex matter. OBJECTIVES:We conducted a multicenter, prospective, observational study to evaluate the efficacy and safety of the buprenorphine transdermal...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2010.06.015
更新日期:2011-04-01 00:00:00