Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0006826 (cancer)
 1,092,456 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper reviews the reported use of nonopioid medications for terminal sedation. To provide a summary of the available literature, an electronic database search was performed. Thirteen series and 1 4 case reports were identified. Various symptoms, including agitation, pain, and confusion, required terminal sedation. Eleven drugs were used in 342 patients. Most patients were also treated with concurrent opioids and received terminal sedation in an inpatient hospice unit. Midazolam was the most common sedative employed. A good response--defined as adequate sedation--ranged between 75% and 100%. The median time to death following the introduction of terminal sedation was greater than 1 day. No agent appears to have superior efficacy or limiting toxicity.
Support Care Cancer 2001 Sep
PMID:Terminal sedation in palliative medicine--definition and review of the literature. 1158 65

Delirium is a common complication in terminally ill cancer patients. Identification of underlying pathologies and prediction of clinical features may improve effective symptom alleviation. This study aims to clarify precipitating factors and their associations with clinical features of terminal delirium. Consecutive hospice inpatients who developed delirium were prospectively evaluated following a structured protocol. Among 237 patients followed until death, 245 episodes of delirium were identified in 213 patients. Precipitating factors for delirium were disclosed in 93% of the 153 cases in which investigations were completed. Mean number of etiologies was 1.8 +/- 1.1 per patient, and two or more factors were recognized in 52%. The main pathologies identified were hepatic failure, medications, prerenal azotemia, hyperosmolality, hypoxia, disseminated intravascular coagulation, organic damage to the central nervous system, infection, and hypercalcemia. Occurrence of hyperactive delirium and the requirement for symptomatic sedation significantly correlated with hepatic failure, opioids, and steroids, while dehydration-related pathologies were significantly associated with hypoactive delirium. Complete recovery was frequently achieved in cases with medication- and hypercalcemia-induced delirium, whereas a low remission rate was related to hepatic failure, dehydration, hypoxia, and disseminated intravascular coagulation. In conclusion, standard examinations can confirm factors potentially contributing to delirium and thereby predict the severity of agitation and clinical outcomes.
 ...
PMID:Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. 1173 62

Sleep difficulty is a prominent concern of cancer patients, yet there has been no large study of the prevalence and nature of sleep disturbance in cancer patients. This cross-sectional survey study examined: (a) the prevalence of reported sleep problems in patients attending six clinics at a regional cancer centre; (b) sleep problem prevalence in relation to cancer treatment; and (c) the nature of reported insomnia (type, duration, and associated factors). For three months, all patients attending clinics for breast, gastrointestinal, genitourinary, gynecologic, lung, and non-melanoma skin cancers were offered a brief sleep questionnaire. Response rate was 87%; the final sample size was 982. Mean age of respondents was 64.9 years (SD 12.5). The most prevalent problems were excessive fatigue (44% of patients), leg restlessness (41%). insomnia (31%), and excessive sleepiness (28%). Chi square tests showed significant variation among clinics in the prevalence of most sleep problems. The lung clinic had the highest or second-highest prevalence of problems. The breast clinic had a high prevalence of insomnia and fatigue. Recent cancer treatment was associated with excessive fatigue and hypersomnolence. Insomnia commonly involved multiple awakenings (76% of cases) and duration > or = 6 months (75% of cases). In 48% of cases, insomnia onset was reported to occur around the time of cancer diagnosis (falling within the period 6 months pre-diagnosis to 18 months post-diagnosis). The most frequently identified contributors to insomnia were thoughts, concerns, and pain/discomfort. In a multivariate logistic regression analysis, variables associated with increased odds of insomnia were fatigue, age (inverse relationship), leg restlessness, sedative/hypnotic use, low or variable mood, dreams, concerns, and recent cancer surgery. This study provides new information about sleep-related phenomena in cancer patients, information which will be useful in planning supportive care services for cancer patients.
 ...
PMID:Sleep disturbance in cancer patients. 1205 48

Patients treated with platinum compounds are subject to hypersensitivity reactions. Our study has highlighted the reactions related to oxaliplatin (OHP) infusion. One hundred and twenty-four patients affected by advanced colorectal cancer were treated with different schedules containing OHP, at the Institute of Haematology and Medical Oncology 'L. and A. Seragnoli' of Bologna and at the Medical Oncology Division of Livorno Hospital. Seventeen patients (13%) showed hypersensitivity reactions after a few minutes from the start of the OHP infusion. Usually, these reactions were seen after 2-17 exposures to OHP (Mean+/-s.e.: 9.4+/-1.07). No patient experienced allergic reactions at his/her first OHP infusion. Eight patients developed a mild reaction consisting of flushing and swelling of the face and hands, itching, sweating and lachrymation. The remaining nine patients showed a moderate-severe reaction with dyspnoea, wheezing, laryngospasm, psycho-motor agitation, tachycardia, precordial pain, diffuse erythema, itching and sweating. Six patients out of 17 were re-exposed to the drug with premedication of steroids and all except one developed the hypersensitivity reaction again. The cumulative dose, the time of exposure to OHP and the clinical features are variable and unpredictable. The risk of developing hypersensitivity reactions in patients treated with a short infusion of OHP cannot be underestimated.
Br J Cancer 2003 Aug 04
PMID:Hypersensitivity reactions related to oxaliplatin (OHP). 1288 15

Arsenic (As) is a common environmental contaminant widely distributed around the world. Human exposure to this metalloid comes from well water and contaminated soil, from fish and other sea organisms rich in methylated arsenic species, and from occupational exposure. It has been reported that human arsenic exposure causes several health problems such as cancer, liver damage, dermatosis, and nervous system disturbances such as polyneuropathy, EEG abnormalities and, in extreme cases, hallucinations, disorientation and agitation. Although there is evidence that arsenic exposure has a toxic effect on the nervous system there are few studies that address this issue. The purpose of this review is to describe what is presently known about the effects of arsenic compounds on the nervous system in humans and rodents and to discuss its possible mechanisms of action.
 ...
PMID:The effects of arsenic exposure on the nervous system. 1296 69

The maintenance of intellectual activity is an important area in the "good death" concept. To clarify the communication capacity levels of terminally ill cancer patients in their final week, and to identify factors contributing to the development of communication capacity impairment and agitated delirium, a retrospective study was performed on 284 consecutive hospice inpatients. The data were collected by chart review, and two independent raters measured the degree of communication capacity and agitation in the last week, using multiple items from the Memorial Delirium Assessment Scale, the Communication Capacity Scale, and the Agitation Distress Scale. The percentages of patients who could achieve complex communication were 43%, 28%, and 13% at 5 days, 3 days, and 1 day before death, respectively. Agitated delirium was identified in 20%. Patients receiving opioids at a dose of > or =120 mg oral morphine equivalents/day one week before death were significantly unable to communicate clearly 3 days before death (0.48 [0.28-0.84], P=0.011). Male gender and the presence of icterus were identified as significant contributors to the development of agitated delirium (odds ratios [95% C.I.]=2.6 [1.4-5.0], P<0.01; 2.4 [1.3-4.4], P< 0.01). These findings demonstrate that communication capacity impairment and agitated delirium are frequently observed in terminally ill cancer patients, and are significantly correlated with a higher dose requirement of opioids and the presence of icterus. To explore the best management to maintain the intellectual activity of dying patients, research should focus on a homogeneous sample of patients receiving high-dose opioids and those with hepatic encephalopathy. In the meanwhile, clinicians should educate patients and family members about the nature of the dying process and help facilitate the completion of life purposes requiring complex mental activities before the latest stages of cancer.
 ...
PMID:Impaired communication capacity and agitated delirium in the final week of terminally ill cancer patients: prevalence and identification of research focus. 1296 31

Toennies, G. (Institute for Cancer Research, Philadelphia, Pa.), L. Iszard, N. B. Rogers, and G. D. Shockman. Cell multiplication studied with an electronic particle counter. J. Bacteriol. 82:857-866. 1961.-Suitable conditions are described for the application of the Counter electronic particle counter to the study of bacterial number and particle size distribution in growing cultures. When Streptococcus faecalis and Escherichia coli were each grown in a different medium, exponential growth was accompanied by a continuous decrease in average particle size. The average apparent particle volume of S. faecalis decreased by about 50% in five generations. Microscopic studies of S. faecalis indicated that this was due to a decrease in the average chain length of the cultures. The following observations concerning average particle size during exponential growth of S. faecalis in a synthetic medium were made: (i) A decreased concentration of tryptophan, serine, or proline resulted in a significant decrease in average particle size. Similar changes in numerous other nutrients produced no or only minor changes. (ii) The addition of a cytoplasmic extract prepared from exponentially growing cells resulted in changes similar to those resulting from the partial withdrawal from the medium of certain nutrients. (iii) The effect of the cytoplasmic extract could be counteracted by the addition of tryptophan. (iv) A limited survey, including the effects of the rate of exponential growth, mechanical agitation, the presence of indoleacetic acid, indole, kinetin, lysozyme, or ascorbate, disclosed no additional factor which significantly influenced the particle size distribution.
 ...
PMID:Cell multiplication studied with an electronic particle counter. 1392 27

The Rainey Hospice House, South Carolina's first stand-alone inpatient facility opened in September 1998. During the year 2000, 220 inpatients were served in the house. Patients ranged in age from 23 to 107 years old (average age 73). Cancer was the most common hospice diagnosis, followed by congestive heart failure, cardiovascular disease and cerebrovascular disease, dementia, cirrhosis, renal failure, and COPD. Thirty-three percent of patients were in the program less than ten days. Over 98 percent of deaths under hospice care were described as peaceful. During 2000, our outpatients and our inpatients were similar in age, insurance coverage, diagnoses, and time in the program. Inpatient hospice is highly valued by families and patients alike. It is especially useful for the following patients: those with uncontrolled symptoms, those with exhausted care givers, those with no caregivers, those who require total care, and those very close to death. The symptoms most likely to precipitate inpatient admission include pain, nausea, confusion, and agitation. Given the graying of South Carolina's population and the increase in outpatient hospice care, more areas of the state will need inpatient facilities in the future.
 ...
PMID:Comfort always. The Rainey Hospice House: South Carolina's first inpatient hospice. 1450 98

Radiofrequency ablation (RFA) is an image guided percutaneous procedure using thermal energy that is used to treat malignant lesions in various organs including liver, breast and lungs. It has also been used bronchoscopically to treat endobronchial tumors. Current passing through tissue from the active electrode leads to ion agitation, which is converted by means of friction into heat leading to irreparable cellular damage and coagulation necrosis. The potential benefits include decreased cost and morbidity, treating patients who are not surgical candidates due to age, co-morbidity or extent of disease and the possibility of performing the procedure on an outpatient basis. The aim is usually to reduce tumor size. Whether it can be used with a curative intent in well localized primary tumors remains to be determined by well designed studies. However, caution should be exercised because selective tumor resection is not the gold standard to treat potentially resectable lung malignancies that are treated with lobectomy. Obviously, lung volume reduction surgery combined with tumor resection has challenged this approach. RFA might be the treatment of choice for multiple lung metastases that are usually approached surgically for long-term remission. A specific indication may also be bilateral pulmonary metastases. Other potential applications might be tumor size reduction by a non-surgical procedure followed by adjuvant chemotherapy. Currently, these thoughts remain only speculations, until proven by clinical trials with medium to long-term follow up. Furthermore, the risk of this procedure for pulmonary application has to be better defined.
 ...
PMID:Radiofrequency heat ablation for lung tumors: potential applications. 1458 81

The objective of this work was to characterize a polymeric paste formulation of the anticancer drug paclitaxel that was injectable through a narrow gauge needle at room temperature and set to a solid implant in vivo for the intratumoral treatment of localized cancer. Pastes were manufactured from a triblock copolymer composed of poly(D,L-lactide-co-caprolactone)-block-polyethylene glycol-block-poly(D,L-lactide-co-caprolactone) (PLC-PEG-PLC) or triblock blended with a low molecular weight polymer methoxypolyethylene glycol (MePEG). Characterization of pastes was performed using differential scanning calorimetry (DSC), gel permeation chromatography (GPC) and drug release studies. Paste integrity in water was measured by determining the degree of fragmentation under initial agitation. MePEG was found to be miscible with the triblock polymer and paclitaxel dissolved in various blends of these polymers up to 15% drug loading. Pastes composed of 40:60 triblock:MePEG blends and 10% paclitaxel were found to inject through a 23-gauge needle and set to a solid pellet in phosphate-buffered saline at 37 degrees C. Such pellets released paclitaxel in a controlled manner over 7 weeks. Pastes composed of 40:60 triblock:MePEG blends containing 10% paclitaxel are proposed as suitable injectable formulations of the drug for intratumoral therapy.
 ...
PMID:The characterization of novel polymeric paste formulations for intratumoral delivery. 1472 34


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>