Abstract:
BACKGROUND:The optimal treatment of malignant ascites (MA) and feasibility of the management with free drainage remain unclear. OBJECTIVE:To study the success of drainage, complications, and survival after paracentesis or insertion of an indwelling tunneled catheter (TC) for the MA performed on a day-case basis. DESIGN AND SETTING:We evaluated 118 paracenteses and 48 insertions of TCs performed in 104 patients with MA at the Palliative Care Outpatient Unit of Tampere University Hospital. RESULTS:Drainage of ascites fluid (median 3700 mL; range 300-13,200 mL) was successful in all cases. The complication rates were 7% and 25% for paracenteses and TCs, respectively. Most of the complications were minor. Repeated procedures were needed in 64% and 10% of the paracenteses and insertions of TCs, respectively, (p < 0.001). Median survival after the first procedure was 40 days (interquartile range, IQR: 17-115). Patients with pancreatic cancer had shorter median survival (19 days; IQR: 9-35) compared with other patients (47 days; IQR: 23-143) (age-adjusted HR 2.73; 95% CI: 1.65-4.52), whereas patients receiving chemotherapy had longer median survival (112 days; IQR: 43-205) compared with patients without chemotherapy (25 days; IQR: 14-52) (age-adjusted HR 2.48; 95% CI: 1.58-3.89). The volume of removed ascites fluid was not associated with survival. CONCLUSIONS:Free drainage of MA seems feasible in an outpatient clinic. Early insertion of TC should be considered to avoid repeated paracenteses. However, in patients with pancreatic cancer, paracentesis might be an accepted alternative due to their short life expectancy.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Korpi S,Salminen VV,Piili RP,Paunu N,Luukkaala T,Lehto JTdoi
10.1089/jpm.2017.0616subject
Has Abstractpub_date
2018-06-01 00:00:00pages
836-841issue
6eissn
1096-6218issn
1557-7740journal_volume
21pub_type
杂志文章abstract:BACKGROUND:Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2017.0684
更新日期:2018-04-01 00:00:00
abstract::Approximately 21 million noninstitutionalized Americans with physical disabilities will ultimately face end-of-life [EOL] issues. Studies have documented disparate care and poorer outcomes for persons with preexisting disabilities who have life-limiting illnesses, which raises the question of how EOL experiences may d...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2011.0506
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND/AIM:Palliative care services (PCS) are recommended to enhance quality of care for hospitalized patients. METHODS:We evaluated the attitudes of liver transplant (LT) providers and perceived barriers to PCS for their patients by conducting a web-based survey of intensive care unit nurses, postgraduate year 1 ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0002
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. OBJECTIVE:To characterize the employment situations of ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0478
更新日期:2017-07-01 00:00:00
abstract::Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
doi:10.1089/jpm.2006.0118
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Palliative care is an essential part of medicine, but most physicians have had no formal opportunity to acquire basic skills in palliative care. In Japan, the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education (PEACE) was launched to provide formal primary p...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2014.0122
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Few studies have focused on men as caregivers at the end-of-life. The objective of this secondary data analysis was to examine the experiences of men involved in end-of-life caregiving, focusing on caregiver strain. METHODS:We used a random sample of Oregon death certificates to telephone survey family care...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2005.8.1167
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Constipation is a common and distressing condition in patients with cancer, especially those taking opioid analgesics. Many institutions prevent and treat constipation with titrated laxatives, which is known as a bowel protocol. An effective and well-tolerated bowel protocol is a very important component of ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2007.0178
更新日期:2008-05-01 00:00:00
abstract::Methadone use as a second-line agent for severe cancer-related pain is increasing in the field of hospice and palliative care. It has a number of qualities that make its use favorable, including lack of known active metabolites and presumed relative safety from adverse effects such as opioid-induced neurotoxicity (OIN...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2016.0502
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. OBJECTIVE:Our aim was to review advance care planning for children with l...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0374
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Improving access to palliative care is an important priority for hospitals as they strive to provide the best care and quality of life for their patients. Even in hospitals with longstanding palliative care programs, only a small proportion of patients with life-threatening illnesses receive palliative care ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章,多中心研究
doi:10.1089/jpm.2011.0301
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Significant gaps exist in the availability of palliative care in rural hospitals and communities, even though rural populations are often disproportionately elderly and chronically ill. Few studies have examined what models of palliative care would be sustainable in a rural community. METHODS:We studied the...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0324
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Opioid dose escalation may cause hyperalgesia, mediated by the N-methyl-D-aspartate (NMDA) pathway. Methadone is an atypical opioid that inhibits hyperalgesia through NMDA-blockade, especially at low doses. OBJECTIVE:To evaluate the efficacy of using very-low-dose methadone as the sole long-acting opioid ag...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0612
更新日期:2013-06-01 00:00:00
abstract:: Background: Systematic measurement of conversational features in the natural clinical setting is essential to better understand, disseminate, and incentivize high quality serious illness communication. Advances in machine-learning (ML) classification of human speech offer ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0270
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Increasing numbers of patients are living with multiple, chronic medical conditions and functional impairments that leave them homebound. Home-based primary and palliative care (HBPC) programs provide access to health care services for this vulnerable population. Homebound patients have high symptom burden u...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0546
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:In February 2002, the palliative care team was established in Ikeda Municipal Hospital to improve palliative care. We investigated changes in the incidences of side effects related to opioids, and evaluated palliative care team activities. METHODS:Regarding inpatients for whom narcotics were prescribed in our ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0355
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Identifying people who are at risk of deteriorating and dying is essential to inform goals of care, appropriate treatment decisions, patient autonomy, and effective end-of-life care. Limited literature exists on predicting survival near the end of life for people with a hematological malignancy. OBJECTIVE:T...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0033
更新日期:2018-12-01 00:00:00
abstract::Resumen Contexto: La Academia Pontificia de la Vida (PAV) es una institución académica de la Santa Sede (Vaticano) cuyo objetivo es promover una visión católica de la ética biomédica. La PAV invitó a una serie de expertos en Cuidados Paliativos (CP) de todo el mundo, de todas las creencias, a desarrollar recomendacion...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0387
更新日期:2018-10-01 00:00:00
abstract::Many physicians and patients do not discuss care at the end of life and most practicing physicians have had little formal education concerning end-of-life discussions. To address this deficiency, our internal medicine residency faculty participated in the National End of Life Residency Education Project and implemente...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/10966210260499131
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Exploring preferences for and barriers to quality end-of-life care is essential to improving care for dying individuals. Young adults often are involved or will be involved in decisions about the care of a loved one, and little research has examined opinions about end-of-life care among this population. RES...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2008.0265
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Many patients with cancer involving the respiratory system suffer from the frequent recurrence of significant, submassive hemoptysis, which may result in invasive procedures, hospital stays, and a reduction in quality of life. Currently, there are no widely accepted noninvasive therapeutic options. Few case ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2015.0167
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Little is currently known about physicians': (1) level of involvement in and comfort delivering palliative care in the inpatient setting, (2) perceived barriers to referring patients to an inpatient Palliative Care Consult Service (PCCS), and (3) attitudes regarding palliative care. METHODS:Eligible partici...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.9656
更新日期:2009-03-01 00:00:00
abstract::For most families, the preferred location of death for their child is home, yet most children still die in the hospital. Many children with life-threatening and life-limiting illness are medically dependent on technology, and palliative transport can serve as a bridge from the intensive care unit to the family's home ...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2018.0301
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The role of emergent palliative surgery in the setting of advanced malignancy remains a subject of controversy. OBJECTIVE:The purpose of this study was to identify clinical predictors of outcome in patients with cancer who undergo nonelective abdominal surgery. SETTING/SUBJECTS:Individuals who underwent ur...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0235
更新日期:2014-01-01 00:00:00
abstract:: Background: Depression is common in the oncology patient population. Little data exist on the impact of depression on health care utilization. Objectives: We evaluated the prevalence of depression and the relationship between d...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2020.0329
更新日期:2021-01-21 00:00:00
abstract:OBJECTIVES:To continuously assess overall quality of life (QOL) and disease progression in patients with amyotrophic lateral sclerosis (ALS) at different stages of the disease and compare the results between these two variables. DESIGN/SUBJECTS:Twenty-six patients with ALS were interviewed with a questionnaire to asse...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2006.9.304
更新日期:2006-04-01 00:00:00
abstract::As part of a Veterans Health Administration (VA) commitment to improve end-of-life care the VA Greater Los Angeles Healthcare System (GLA) implemented Pathways of Caring, a 3-year demonstration project targeting patients with inoperable lung cancer and advanced heart failure and chronic lung disease. The program utili...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662103322515428
更新日期:2003-10-01 00:00:00
abstract::Louisiana State Penitentiary (Angola) has a large population of aging men serving long sentences with little hope of reprieve. Eighty-five percent of the 5108 inmates currently incarcerated at Angola are expected to die there. The prison, in partnership with University Hospital Community Hospice in New Orleans, has cr...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102760269797
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF. OBJECTIVE:We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2013.0680
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The use of complementary and alternative medicines (CAM) in patients with cancer is well recognized. Little is known, however, about the use of CAM in children with cancer during the end-of-life period. METHODS:We interviewed 96 parents of children who had died of cancer in Melbourne, Australia between 1996...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0150
更新日期:2012-11-01 00:00:00