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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 3 (1995), S. 164-167 
    ISSN: 1433-7339
    Keywords: Opioids ; Analgesia Palliative care ; Cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This declaration was formulated by consensus of the various government agencies and other organizations involved. It is hoped that it will be widely circulated.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 4 (1996), S. 157-157 
    ISSN: 1433-7339
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 5 (1997), S. 205-211 
    ISSN: 1433-7339
    Keywords: Key words Dehydration ; Terminally ill patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The need to treat dehydration in terminally ill patients has become a very controversial topic. Numerous reports in the literature illustrate opposing viewpoints from both clinical and ethical perspectives. Arguments for the maintenance of hydration in terminally ill patients have tended to come from "the traditional medical model". Many health care professionals looking after terminally ill patients have reacted to the generalized use of intravenous fluids in dying patients and the perceived negative effects of this management. Our palliative care group has argued that the viewpoint that dehydration in dying patients is not a cause of symptom distress overlooks commonly reported problems, such as agitated delirium, that can be prevented or reversed by the management of dehydration. This review presents a summary of the traditional arguments, a different perspective on the controversy, biochemical parameters reported in terminally ill cancer patients, recent dehydration research, and the use of hypodermoclysis and rectal hydration. We conclude that the data reported to date are insufficient to allow a final conclusion on the benefit or harm of dehydration in terminally ill patients. Nevertheless, it is worth considering that while some dying patients may not suffer any ill effects from dehydration, there may be others who do manifest symptoms, such as confusion or opioid toxicity, that might be alleviated or prevented by parenteral hydration.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-7339
    Keywords: Key words Cancer ; Pain ; Morphine ; Suppositories ; Controlled release
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We evaluated the safety and efficacy of controlled-release morphine sulphate suppositories administered 12-hourly and once daily in patients with chronic cancer in a randomized double-blind crossover trial. Pain was assessed using a 100-mm VAS pain scale and a five-point ordinal pain scale. The VAS pain intensity score was 17.5±17.2 after suppositories every 12 h, versus 16.2±13.4 after suppositories every 24 h (difference not significant). The difference between the mean VAS pain scores with 12-hourly and once-daily dosing was 1.3 mm (not significant). The mean ordinal pain scores were 1.0±0.7 versus 1.0±0.6 for 12-hourly and once-a-day dosing, respectively (not significant). A retrospective power analysis indicated that a difference of 5.9 mm was detectable, even with only 6 patients. Adverse events noted were constipation, nausea, anorexia, and dry mouth. The use of once-a-day controlled-release morphine suppository is a more convenient and equally effective alternative to twice a day dosing.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 4 (1996), S. 147-150 
    ISSN: 1433-7339
    Keywords: Terminal cancer Hydration ; Route of administration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this retrospective study we reviewed the volume and modality of hydration of consecutive series of terminal cancer patients in two different settings. In a palliative care unit 203/290 admitted patients received subcutaneous hydration for 12 ± 8 days at a daily volume of 1015 ± 135 ml/day. At the cancer center, 30 consecutive similar patients received intravenous hydration for 11.5 ± 5 days (P 〉 0.2) but at a daily volume of 2080 ± 720 ml/day (P 〈 0.001). None of the palliative care unit patients required discontinuation of hydration because of complications. Hypodermoclysis was administered mainly as a continuous infusion, an overnight infusion, or in one to three 1-h boluses in 62 (31%), 98 (48%) and 43 (21%) patients, respectively. Our findings suggest that, in some settings, patients may be receiving excessive volumes of hydration by less comfortable routes such as the intravenous route. Increased education and research in this area are badly needed.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 1 (1993), S. 298-304 
    ISSN: 1433-7339
    Keywords: Cancer cachexia ; Nutrition ; Anorexia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cancer cachexia is highly prevalent in patients with advanced cancer. Its main clinical manifestation is profound anorexia. Progestational drugs have shown meaningful effects on appetite, food intake, and nutritional status in patients with advanced cancer and AIDS, and could be useful in managing anorexia. Corticosteroids also seem to produce increased appetite, but these effects are short-lived. Cyproheptadine, hydrazine sulfate, and cannabinoids also are being studied in the management of cancer-induced anorexia, but their role has not yet been clearly established. Future research should evaluate how the different drugs affect specific symptoms associated with cachexia.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 2 (1994), S. 77-78 
    ISSN: 1433-7339
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1433-7339
    Keywords: Key words Assessment ; Expectations ; Distress and conflict management ; Teaching tool ; Functional status
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Continuous accurate assessment is mandatory for palliative care of good quality. One of the major objectives in palliation is to meet the expectations of patient, family members and care givers. While a number of valid tools for assessing symptoms or function are available, there are unfortunately no recognized instruments for assessing expectations. The mismatch of expectations and the actual situation is a major source of distress and conflict. The present paper describes a simple way of visualizing this distress and conflict graphically. In our experience, this method is helpful in raising awareness of and enabling analysis of distress and conflict in patients, family members, and health care workers. It is also useful in the education of students and members of the palliative care team. It is illustrated with reference to four clinical situations.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 6 (1998), S. 331-331 
    ISSN: 1433-7339
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 6 (1998), S. 365-372 
    ISSN: 1433-7339
    Keywords: Key words Brain ; Corticosteroids ; Seizures ; Radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The development of brain metastases in patients with advanced cancer is associated with increased morbidity and diminished longevity. Palliative treatment modalities focus predominantly on improving quality of life. Well-established beneficial treatments include the use of corticosteroids, radiotherapy, and surgery. Management issues that require further exploration and clarification include the dosages of glucocorticoids, the prophylactic use of anticonvulsants and the indications for radiosurgery.
    Type of Medium: Electronic Resource
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