Browse Items · Pediatric Palliative Care Library

Pediatric sedation with analgesia

Sedation with analgesia is frequently required to perform painful or invasive procedures in children. The best medication combination for pediatric sedation with analgesia is yet to be identified. Sixty-four of 243 total sedation with analgesia…

A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease

Recently, patient controlled analgesia (PCA) has gained prominence in the treatment of pain for children suffering from vaso-occlusive crisis associated with sickle cell disease. Because there are several different regimens that can be used for PCA,…

Pain and symptom control in terminally ill children

The management of pain in terminally ill pediatric patients has incalculable benefits to patients, their families, and physicians and nurses. A therapeutic management plan is dependent on a thorough understanding of the causes of pain in these…

The McGill Quality of Life Questionnaire: a measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability

This is the first report on the McGill Quality of Life Questionnaire (MQOL), a questionnaire relevant to all phases of the disease trajectory for people with a life-threatening illness. This questionnaire differs from most others in three ways: the…

Comparison of morphine and methadone for prevention of postoperative pain in 3- to 7-year-old children

A randomized, double-blind, prospective study was performed to determine the effects of perioperative administration of morphine or methadone on postoperative analgesic requirements and pain scores in 35 children aged 3 to 7 years undergoing major…

Reviewing audit: barriers and facilitating factors for effective clinical audit

OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a…

Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain

OBJECTIVES: (1) To determine the pharmacokinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in children with cancer receiving morphine as immediate-release morphine liquid or sustained-release tablets. (2) To…

Efficacy of psychotropic drugs for reducing self-injurious behavior in the developmental disabilities

Self-injurious behavior (SIB) is a serious and moderately prevalent problem behavior among developmentally disabled persons, and it frequently leads to treatment with psychotropic medication. The empirical literature relating to the efficacy of…

Tags: 1993, Adrenergic beta-Antagonists/tu [Therapeutic Use], Aman MG, Annals Of Clinical Psychiatry : Official Journal Of The American Academy Of Clinical Psychiatrists, Anti-Anxiety Agents/tu [Therapeutic Use], Antidepressive Agents/cl [Classification], Antidepressive Agents/tu [Therapeutic Use], Antipsychotic Agents/ad [Administration & Dosage], Antipsychotic Agents/pd [Pharmacology], Antipsychotic Agents/tu [Therapeutic Use], Backlog, Comparative Study, Dopamine/me [Metabolism], Female, Human, Journal Article, Lithium Carbonate/tu [Therapeutic Use], Male, Mental Retardation/co [Complications], Mental Retardation/di [Diagnosis], Naloxone/tu [Therapeutic Use], Naltrexone/tu [Therapeutic Use], P.H.S., Receptors, Self-Injurious Behavior/co [Complications], Self-Injurious Behavior/dt [Drug Therapy], Support, Treatment Outcome, U.S. Gov't

Opioid analgesics: comparative features and prescribing guidelines

The term 'opioid' is a generic term for naturally occurring, semisynthetic and synthetic drugs which combine with opioid receptors to produce physiological effects and which are stereospecifically antagonised by naloxone. For clinical purposes,…

Tags: 1996, Analgesics, Backlog, Cherny NI, Comparative Study, Drug, Drugs, Humans, Journal Article, Opioid/administration & dosage/adverse effects/therapeutic use, Pain/drug Therapy, Prescriptions

Pain management in the emergency department: patterns of analgesic utilization

OBJECTIVE: To compare the use of analgesia in children to adults in 3 different emergency department (ED) settings. METHODS: Forty adult and 40 pediatric ED charts were randomly selected for review at each of 3 institutions: an academic medical…

The treatment of lateral epicondylitis by iontophoresis of sodium salicylate and sodium diclofenac

OBJECTIVE: To investigate the effectiveness of sodium diclofenac and sodium salicylate applied by topical iontophoresis and to compare them in the treatment of lateral epicondylitis. SUBJECTS: Forty patients with lateral epicondylitis were randomized…

Tags: 1998, Adult, Anti-Inflammatory Agents, Backlog, Clinical Rehabilitation, Comparative Study, Demirtas RN, Diclofenac/administration & Female, Humans, Iontophoresis, Journal Article, Male, Middle Aged, Non-Steroidal/administration & dosage, Oner C, Pain Measurement, Random Allocation, Sodium Salicylate/administration & Tennis Elbow/drug therapy

Empowerment through photo novella: portraits of participation

Photo novella does not entrust cameras to health specialists, policymakers, or professional photographers, but puts them in the hands of children, rural women, grassroots workers, and other constituents with little access to those who make decisions…

Not ready for hospice: characteristics of patients in a pre-hospice program

CONTEXT: There are many patients with terminal illness for whom hospice care would be appropriate, but they either never enroll or enroll very late. In a pre-hospice program designed to help patients make the transition into hospice, we observed that…

Using a treatment-tradeoff method to elicit preferences for the treatment of locally advanced non-small-cell lung cancer

The study was designed to evaluate a treatment-tradeoff method for its potential in helping lung cancer patients make treatment decisions. A treatment-tradeoff interview was conducted to determine how patients weighed potential survival benefits…

Nutrition-related growth failure of children with quadriplegic cerebral palsy

Growth failure and nutritional status were evaluated in 142 children with quadriplegic cerebral palsy, aged between two and 18 years. Linear growth was assessed by upper-arm and lower-leg lengths: both means were significantly reduced. Mean…

Increased concentration of beta-endorphin in sera of patients with psoriasis and other inflammatory dermatoses

Serum beta-endorphin was quantified by radioimmunoassay in 71 patients with psoriasis vulgaris, other chronic inflammatory skin diseases with T-cell infiltrates [atopic dermatitis (n = 25), and systemic sclerosis (n = 34)], and 100 healthy subjects.…

Epidural analgesia for postoperative pain control in children

Ninety-eight continuous postoperative epidurals were administered to 87 children. The patients were divided into two groups: group I included 63 cases in which a 0.0625-0.25% solution of bupivacaine was continuously administered; group II included 35…

Meaning in caregiving and its contribution to caregiver well-being.

This multivariate study examined the relationship between meaning in caregiving--positive beliefs about the caregiving situation and the self as caregiver--and the psychological well-being of 131 informal caregivers to community-residing frail…

Stressors and well-being among caregivers to older adults with dementia: the in-home versus nursing home experience

We examined differences in stressors and well-being for caregivers who care for a relative with dementia at home and those who had placed their relative in a nursing home. The groups did not differ in depression or somatic complaints, but nursing…

Comparison of different bolus doses of morphine for patient-controlled analgesia in children

Forty children undergoing appendicectomy were allocated randomly to receive one of two PCA regimens with morphine. Group B10 received bolus doses of 10 micrograms kg-1 and group B20 received bolus doses of 20 micrograms kg-1. In both groups there was…

Patient-controlled analgesia with low dose background infusions after lower abdominal surgery in children

Forty-five children (aged 6-12 yr) undergoing appendicectomy received one of three analgesic regimens using patient-controlled analgesia (PCA) with morphine: no background infusion (BO); background infusion 4 micrograms kg-1 h-1 (B4); background…

Comparing parent loss with sibling loss

The death of a loved one is a traumatic loss for children, but little attention has been paid to how children's responses vary according to who died--a parent or a sibling. This article reports the findings of a comparison between children's…

Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test

Research on dispositional optimism as assessed by the Life Orientation Test (Scheier & Carver, 1985) has been challenged on the grounds that effects attributed to optimism are indistinguishable from those of unmeasured third variables, most notably,…

A randomized, controlled trial of intravenous clodronate in patients with metastatic bone disease and pain

To evaluate the effectiveness of intravenous clodronate in ameliorating refractory bone pain in patients with metastatic bone disease, 60 patients with established osseous metastases and persistent bone pain were randomized to receive either…

Patient-controlled analgesia for mucositis pain in children: a three-period crossover study comparing morphine and hydromorphone

OBJECTIVES: (1) To test the safety and efficacy of a clinical protocol for administering opioid by using patient-controlled analgesia (PCA) for the management of mucositis pain in children after bone marrow transplantation, (2) to compare the…

T-lymphocyte concentrations of cholecystokinin-8 and beta-endorphin in eating disorders: II. Bulimia nervosa

Concentrations of cholecystokinin-8 (CCK-8) and beta-endorphin (beta-EP) in T-lymphocytes of 26 women with bulimia nervosa (BN) and in 26 age- and sex-matched healthy comparison subjects were measured. Ten patients were then treated with 300 mg/day…

T-lymphocyte cholecystokinin-8 and beta-endorphin concentrations in eating disorders: I. Anorexia nervosa

Baseline concentrations of cholecystokinin-8 (CCK-8) and beta-endorphin (beta-EP) were measured in T-lymphocytes from 33 restricting patients with anorexia nervosa (AN-R), 23 binging/purging patients with anorexia nervosa (AN-BP), and 24 healthy…

Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain

To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of…

Intermittent but not continuous inescapable footshock stress affects immune responses and immunocyte beta-endorphin concentrations in the rat

It is well known that a variety of stressors influence immune responses. The opioid peptide-beta-endorphin (BE) is deeply involved in stress responses, is synthesized in cells of the immune system, and participates in the modulation of immune…

Comparative clinical efficacy and safety of a novel controlled-release oxycodone formulation and controlled-release hydromorphone in the treatment of cancer pain

BACKGROUND: The use of oxycodone to treat chronic cancer pain has been hampered by its short elimination half-life, which necessitates administration every 4 hours. This study compared the clinical efficacy and safety of a novel oxycodone formulation…

Tags: 1997, Analgesics, Babul N, Backlog, Cancer, Comparative Study, Cross-Over Studies, Delayed-Action Preparations, Double-Blind Method, Drug Evaluation, Female, Hagen NA, Humans, Hydromorphone/administration & Male, Journal Article, Middle Aged, Neoplasms/complications, Opioid/administration & dosage, Oxycodone/administration & Pain/drug therapy

Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine

BACKGROUND. When a change of opioid is considered, equianalgesic dose tables are used. These tables generally propose a dose ratio of 5:1 between morphine and hydromorphone. In the case of a change from subcutaneous hydromorphone to methadone, dose…

Dying children need help too

1979

Tags: 1979, Backlog, British Medical Journal, Case Report, Chapman JA, Child, Child Care/methods/standards, Comparative Study, Cystic Fibrosis/therapy, Female, Goodall J, Human, Journal Article, Terminal Care/methods/standards

An alternative in terminal care: results of the National Hospice Study

Hospice is a program of supportive services for terminally ill patients and their families, provided either at home or in designated inpatient settings, which is purported to improve patient and family quality of life at lower cost than conventional…

An overview of National Hospice Study findings

View through a window may influence recovery from surgery

Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences.…

Sublingual absorption of selected opioid analgesics

Ongoing interest in the improvement of pain management with opioid analgesics had led to the investigation of sublingual opioid absorption. The present report determined the percent absorption of selected opioid analgesics from the oral cavity of…

Respiratory function in handicapped children

The aim of this study was to evaluate respiratory function of severely handicapped children. Tidal volumes and respiratory rates were determined in a total of 130 children with different clinical motor abilities. Tidal volume of non-sitters (n = 39)…

Death of a child at home or in the hospital: subsequent psychological adjustment of the family

Twenty-four families who had participated in a Home Care Program for children terminally ill with cancer and 13 families of similar children who had died in the hospital completed inventories on parent and sibling personality as well as family…

Beta-endorphin disregulation in autistic and self-injurious behavior: a neurodevelopmental hypothesis

Peptides derived from pro-opiomelanocortin (POMC) influence neurodevelopmental processes. Earlier studies indicated that MSH/ACTH compounds improved behavioral efficiency in retarded individuals. Recent studies have shown that opiate blockers reduce…

Tags: 1988, Adult, Autistic Disorder/drug therapy/physiopathology, Backlog, beta-Endorphin/blood/physiology, Clinical Trials, Comparative Study, Developmental Disabilities/drug therapy/physiopathology, Homeostasis, Humans, Journal Article, Male, Naloxone/therapeutic use, Naltrexone/diagnostic use, Non-U.S. Gov't, Research Support, Sandman CA, Synapse (new York, N.Y.)

Hospital charges for a community inpatient palliative care program

Defining financial parameters of palliative care (PC) is important for providing sustainable programming. In our study, we evaluated hospital length of stay (LOS) and charges for the first 164 inpatient PC consultations performed by the Advanced…

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