Browse Items · Pediatric Palliative Care Library

Clinical experience with oral methadone administration in the treatment of pain in 196 advanced cancer patients

PURPOSE: The aims of this study were to describe the analgesia, side effects, and dosage and the causes of suspension of treatment in a large sample of advanced cancer patients with pain after treatment with oral methadone from 7 to 90 days. PATIENTS…

Intravenous morphine for emergency treatment of cancer pain

Despite the wide use of the World Health Organization (WHO) analgesic ladder for the relief of cancer pain, it is not uncommon to find patients presenting with severe pain to palliative care centres. This is more so in the developing world, where…

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…

Ketamine-fentanyl-midazolam infusion for the control of symptoms in terminal life care

In this report, we describe nine terminally ill patients with metastatic cancer who were treated with an intravenous infusion consisting of ketamine (2 mg/ml)/fentanyl (5 micrograms/ml)/midazolam (0.1 mg/ml) (K/F/M) to control pain after traditional…

Status epilepticus in children: aetiology, treatment, and outcome

This retrospective study includes 65 children treated for status epilepticus at Tampere University Hospital in Finland. Aetiology of the condition, effectiveness of the treatment protocol, including short barbiturate anaesthesia to prevent prolonged…

Tags: 1997, Adolescence, Age Distribution, Anesthetics, Anticonvulsants, Backlog, Barbiturates/ad [Administration & Dosage], Chi-Square Distribution, Child, Developmental Medicine & Child Neurology, Diazepam/ad [Administration & Dosage], Drug Administration Schedule, Electroencephalography, Encephalitis/co [Complications], Eriksson KJ, Female, Follow-up Studies, Human, Infant, Intravenous/ad [Administration & Dosage], Journal Article, Koivikko MJ, Male, Meningitis, Nervous System Diseases/ep [Epidemiology], Neuropsychological Tests, Non-U.S. Gov't, Preschool, Prevalence, Retrospective Studies, Risk Factors, Septic/co [Complications], Sex Distribution, Shock, Status Epilepticus/di [Diagnosis], Status Epilepticus/dt [Drug Therapy], Status Epilepticus/ep [Epidemiology], Status Epilepticus/et [Etiology], Streptococcal Infections/co [Complications], Support, Time Factors, Treatment Outcome, Viral/co [Complications]

The use of haloperidol in the agitated, critically ill pediatric patient with burns

Haloperidol has become the drug of choice for sedation of the acutely agitated, delirious adult patient in the critical care setting because of its well-documented efficacy and lack of major side effects. Its use in the critically ill pediatric…

The natural history of degenerative ataxia: a retrospective study in 466 patients

The aim of the present study was (i) to compare disease progression and survival in different types of degenerative ataxia, and (ii) to identify variables that may modify the rate of disease progression. We included patients suffering from…

Experience with neonatal palliative care consultation at the Medical College of Wisconsin-Children's Hospital of Wisconsin

At Children's Hospital of Wisconsin there is a pediatric palliative care consultation service that serves a diverse patient population, including infants. However, the value of a palliative care consultation for infants has not been well evaluated.…

Tags: 2001, Backlog, Hospitals, Humans, Infant, Intensive Care Units, Journal Article, Journal of Palliative Medicine, Leuthner SR, Neonatal, Neonatology, Newborn, Palliative Care, Pediatric, Pierucci R, Referral And Consultation, Retrospective Studies, Wisconsin

Disorders of movement in Leigh syndrome

Leigh syndrome (LS) is the clinical prototype of a genetically-determined mitochondrial encephalopathy. Twenty-two of 34 patients with LS had evidence of a movement disorder (MD). Dystonia, the most common MD, was present in 19 cases, rigidity in 4,…

Follow-up in children with Joubert syndrome

Although Joubert syndrome (JS) was first reported in 1969 by Joubert et al (21), the long-term outcome is not yet documented. We report 19 children (4 pairs of siblings) from a single institution diagnosed with JS. Nine children were last seen…

Efficacy and complications of morphine infusions in postoperative paediatric patients

The aim of the study was to evaluate the efficacy and the incidence of clinically significant adverse drug reactions (ADRs) in paediatric patients receiving continuous intravenous morphine infusions for acute postoperative pain. Definitions were…

Perceptions of control and long-term recovery from rape

The relationship between perceptions of control and symptoms of both long-term depression and post-traumatic stress was examined. Enduring beliefs of personal competence and control were found to be associated with lower rates of depression and…

Medical care utilization by incurable cancer patients in a Swedish county

A retrospective study of patients with cancer diagnoses treated at a Swedish county hospital was carried out in order to analyse medical care utilization by incurable cancer patients. All 208 patients customarily treated at the Department of General…

Control of severe pain in children with terminal malignancy

OBJECTIVE: To identify the characteristics of the subset of children with malignancy in whom massive opioid infusions are needed during the terminal phase. DESIGN: Retrospective review of the records of the 199 patients who died of malignancy after…

Niemann-Pick disease type C: diagnosis and outcome in children, with particular reference to liver disease

The records of 52 children with Niemann-Pick disease type C were reviewed to establish whether the disease process and outcome varied with the initial clinical pattern; 34 children (65%) had cholestatic liver disease and hepatosplenomegaly in…

Satisfaction with palliative care: what should we be aware of?

This review addresses some of the methodological, theoretical and technical issues related to using satisfaction as an outcome measure of the quality of palliative care. The components of palliative care are presented, and the different approaches…

Tags: 1998, Backlog, Fakhoury WK, Humans, International Journal Of Nursing Studies, Journal Article, Outcome Assessment (Health Care)/organization & administration, Palliative Care/psychology, Palliative Care/standards, Patient Satisfaction, Prospective Studies, Quality Of Health Care, Research Design, Retrospective Studies

The course of the terminal phase in patients with amyotrophic lateral sclerosis

The fear of "choking to death" is on the mind of most patients suffering from amyotrophic lateral sclerosis (ALS). So far, however, there have been no systematic surveys concerning the dying phase in a general ALS population. We therefore performed a…

Methadone is safe for treating hospitalized patients with severe pain

PURPOSE: Methadone is still regarded as a second line opioid for patients suffering from severe pain, and is rarely used in hospitalized patients. The infrequent use of methadone is probably due to its long plasma half-life that could lead to…

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…

Life threatening illness and hospice care.

A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening…

Juvenile neuronal ceroid lipofuscinosis (JNCL): quantitative description of its clinical variability

The clinical courses of 17 JNCL patients were analyzed retrospectively with the use of a simple, disease-specific scoring system. The mean observation period was 14 years (range 8-18 years). Scores of 0 (maximal dysfunction) to 3 (normal function)…

Tags: 1988, Acta Paediatrica, Adolescent, Adult, Albani M, Backlog, Child, Female, Follow-up Studies, Humans, Journal Article, Kohlschutter A, Laabs R, Longitudinal Studies, Male, Neuronal Ceroid-Lipofuscinoses/diagnosis, Retrospective Studies

Wilson's disease: a longitudinal study of psychiatric symptoms

One hundred and twenty-nine cases of Wilson's disease (WD) were assessed at index admission and two follow-ups (F1 and F2) on a range of clinical and biochemical variables. The commonest psychiatric symptoms throughout were incongruous behavior,…

Feeding jejunostomy in patients with neurologic disorders

A retrospective study of 54 patients who underwent feeding jejunostomy because of dysphagia on a neurologic basis was performed to determine risk factors affecting a postoperative mortality of 33% and six-month mortality of 67%. Advanced patient age,…

A measure of the quality of dying and death. Initial validation using after-death interviews with family members

A reliable and valid measure of the quality of the dying experience would help clinicians and researchers improve care for dying patients. To describe the validity of an instrument assessing the quality of dying and death using the perspective of…

Clinical spectrum, morbidity, and mortality in 113 pediatric patients with mitochondrial disease

OBJECTIVES: The aim of this study was to elucidate the frequency of major clinical manifestations in children with mitochondrial disease and establish their clinical course, prognosis, and rates of survival depending on their clinical features.…

Circumstances surrounding the deaths of hospitalized children: opportunities for pediatric palliative care.

OBJECTIVES: Little is known regarding the assessment and treatment of symptoms during end-of-life (EOL) care for children. This study was conducted to describe the circumstances surrounding the deaths of hospitalized terminally ill children,…

Where do children with complex chronic conditions die? Patterns in Washington State, 1980-1998

OBJECTIVE: Little is known about factors that influence whether children with chronic conditions die at home. We sought to test whether deaths attributable to underlying complex chronic conditions (CCCs) were increasingly occurring at home and to…

Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society

OBJECTIVE: To review evidence on the pharmacologic treatment of the child with migraine headache. METHODS: The authors reviewed, abstracted, and classified relevant literature. Recommendations were based on a four-tiered scheme of evidence…

Natural history of nonketotic hyperglycinemia in 65 patients

BACKGROUND: Glycine encephalopathy, also known as nonketotic hyperglycinemia (NKH), is an autosomal recessive disorder caused by a defect in the glycine cleavage system. NKH is classically associated with neonatal apnea, lethargy, hypotonia, and…

Tags: 2004, Adolescent, Age of Onset, AIM, Anticonvulsants/tu [Therapeutic Use], Apnea/et [Etiology], Apnea/th [Therapy], Applegarth D, Artificial, Backlog, Child, Corpus Callosum/ab [Abnormalities], Disease Progression, Female, Glycine/bl [Blood], Glycine/cf [Cerebrospinal Fluid], Hamosh A, Health Surveys, Hoover-Fong JE, Humans, Hydrocephalus/ep [Epidemiology], Hydrocephalus/et [Etiology], Hyperglycinemia, IM, Infant, Journal Article, Juvenile/dt [Drug Therapy], Juvenile/ep [Epidemiology], Juvenile/et [Etiology], Male, Myoclonic Epilepsy, Neurology, Newborn, Nonketotic/co [Complications], Nonketotic/ep [Epidemiology], Nonketotic/me [Metabolism], Nonketotic/mo [Mortality], Nystagmus, Pathologic/ep [Epidemiology], Pathologic/et [Etiology], Pregnancy, Pregnancy Complications/ep [Epidemiology], Preschool, Psychomotor Disorders/ep [Epidemiology], Psychomotor Disorders/et [Etiology], Questionnaires, Registries, Respiration, Retrospective Studies, Seizures/dt [Drug Therapy], Seizures/ep [Epidemiology], Seizures/et [Etiology], Sex Factors, Shah S, Survival Analysis, Toone J, Van Hove JL

The efficacy and side effects of continuous infusion intravenous morphine (CIVM) for pain and symptoms due to advanced cancer

Morphine is the strong opioid of choice in the management of moderate-to-severe chronic cancer pain. The preferred route of administration is oral, in individually titrated doses, regularly scheduled around the clock We conducted a retrospective…

The clinical spectrum of mitochondrial disease in 75 pediatric patients

The clinical presentation of mitochondrial disorders in childhood is highly variable causing difficulties in diagnosis and management. We assessed records of 75 children (48 male, 27 female) with a biochemically and/or molecularly established…

Open lung biopsy in neonatal and paediatric patients referred for extracorporeal membrane oxygenation (ECMO)

BACKGROUND: This study was undertaken to determine the usefulness, safety, and most appropriate timing of open lung biopsy in infants and children considered for and on extracorporeal membrane oxygenation (ECMO) for respiratory failure. METHODS: A…

Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States

OBJECTIVE: To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness. DESIGN: Retrospective cohort study based on claims…

Validation of a decision rule identifying febrile young girls at high risk for urinary tract infection

OBJECTIVE: To validate a previously published clinical decision rule to predict risk of urinary tract infection in febrile young girls. METHODS: We performed a retrospective case-control study at a children's hospital emergency department in a…

A descriptive study of children dying in the pediatric intensive care unit after withdrawal of life-sustaining treatment

OBJECTIVE: To examine physiologic and therapeutic changes following withdrawal of life-sustaining treatment in children. DESIGN: Retrospective chart review. SETTING: University-affiliated tertiary care pediatric hospital. PATIENTS: All patients who…

Mechanical ventilation in Ontario, 1992-2000: incidence, survival, and hospital bed utilization of noncardiac surgery adult patients

OBJECTIVE: Mechanical ventilation is a common therapy used in caring for critically ill patients, but its epidemiology is poorly understood. We describe population-based, temporal trends in the incidence, survival, and hospital bed utilization of…

Critical care medicine in the United States 1985-2000: an analysis of bed numbers, use, and costs

OBJECTIVE: To establish a database that permits description and analysis of the evolving role, patterns of use, and costs of critical care medicine (CCM) in the United States from 1985 to 2000. DESIGN: Retrospective study combining data from federal…

Tags: 2004, Backlog, Bed Occupancy/statistics & numerical data, Comparative Study, Critical Care Medicine, Critical Care/economics/statistics & numerical data/trends/utilization, Databases, Factual, Greenstein RJ, Halpern NA, Journal Article, Non-U.S. Gov't, Pastores SM, Research Support, Retrospective Studies, United States

Browse Items (209 total)