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PURPOSE OF REVIEW Dyspnea is a common symptom experienced by patients suffering from life-limiting illnesses. This review aims to summarize the nonpharmacological therapies that exist to treat this complex symptom. RECENT FINDINGS There is a wide array of nonpharmacological therapies to target the symptom of dyspnea by either changing physiologic factors(More)
PURPOSE In 1998, the American Society of Clinical Oncology (ASCO) published a special article regarding palliative care and companion recommendations. Herein we summarize the major accomplishments of ASCO regarding palliative cancer and highlight current needs and make recommendations to realize the Society's vision of comprehensive cancer care by 2020. (More)
Palliative and end-of-life care is changing in the United States. This dynamic field is improving care for patients with serious and life-threatening cancer through creation of national guidelines for quality care, multidisciplinary educational offerings, research endeavors, and resources made available to clinicians. Barriers to implementing quality(More)
BACKGROUND Integrating end-of-life care (EOL) education into medical residency programs requires knowledge of what programs currently teach and what residents learn. OBJECTIVE Evaluate EOL teaching content and practices in internal medicine residency programs and the EOL knowledge of their faculty and residents. DESIGN An interinstitutional pilot study.(More)
The hospice approach to terminal care will benefit patients with advanced chronic illnesses other than cancer. This article describes general criteria that will help clinicians assess when patients may be appropriately referred for hospice care. Common illnesses, such as dementia, heart disease, lung disease, and renal failure for which terminal care in(More)
BACKGROUND Cancer pain is usually managed by oncologists, occasionally with input from specialists in hospice and palliative medicine (PLM) or pain medicine (PMD). We evaluated the knowledge of cancer pain management in these three specialty groups. METHODS Eight vignettes depicting challenging scenarios of patients with poorly controlled pain were(More)
PURPOSE To present guidance for patients and physicians regarding the use of radiotherapy in the treatment of bone metastases according to current published evidence and complemented by expert opinion. METHODS AND MATERIALS A systematic search of the National Library of Medicine's PubMed database between 1998 and 2009 yielded 4,287 candidate original(More)
One hundred patients admitted to an acute hospice/palliative care unit in a U.S. teaching hospital were evaluated using a standardized data acquisition tool that assessed the presence of physical symptoms and attitudes concerning admission to such a specialty unit. Patients entering the unit between June 1995 and October 1995 completed the tool within 24(More)
Methylnaltrexone, a peripherally-acting quaternary opioid antagonist, is an investigational treatment for opioid-induced constipation in patients with advanced illness. This randomized, parallel-group, repeated dose, dose-ranging trial included a double-blind phase for one week followed by an open-label phase for a maximum of three weeks. Opioid-treated(More)
BACKGROUND Subcutaneous hydration has potential advantages over intravenous. Despite studies supporting the efficacy and safety of subcutaneous hydration it has not been studied extensively to date either with or without hyaluronidase. OBJECTIVES To compare flow rate, tolerability, and safety of gravity-driven subcutaneous fluid administration with and(More)