scholarly journals MEK inhibition appears to improve symptom control in primary NRAS-driven CNS melanoma in children

2017 ◽  
Vol 116 (8) ◽  
pp. 990-993 ◽  
Author(s):  
Veronica A Kinsler ◽  
Patricia O'Hare ◽  
Thomas Jacques ◽  
Darren Hargrave ◽  
Olga Slater
Keyword(s):  
Symptom Control ◽  
Mek Inhibition ◽  
Improve Symptom

Advance care planning for patients with COVID-19: a communication guide

2021 ◽  
pp. 1-6
Author(s):  
Natasha Palipane ◽  
Abi Ponnampalampillai ◽  
Srirupa Gupta
Keyword(s):  
Advance Care Planning ◽  
Symptom Control ◽  
Patient Choice ◽  
High Morbidity ◽  
Care Planning ◽  
Goals Of Care ◽  
Disease Trajectory ◽  
Improve Symptom ◽  
Inappropriate Admissions ◽  
Advance Care

In view of the high morbidity and mortality associated with COVID-19, early and honest conversations with patients about goals of care are vital. Advance care planning in its traditional manner may be difficult to achieve given the unpredictability of the disease trajectory. Despite this, it is crucial that patients' care wishes are explored as this will help prevent inappropriate admissions to hospital and to critical care, improve symptom control and advocate for patient choice. This article provides practical tips on how to translate decisions around treatment escalation plans into conversations, both face-to-face and over the phone, in a sensitive and compassionate manner. Care planning conversations for patients with COVID-19 should be individualised and actively involve the patient. Focusing on goals of care rather than ceilings of treatment can help to alleviate anxiety around these conversations and will remind patients that their care will never cease. Using a framework such as the ‘SPIKES’ mnemonic can help to structure this conversation. Verbally conveying empathy will be key, particularly when wearing personal protective equipment or speaking to relatives over the phone. It is also important to make time to recognise your own emotions during and/or after these conversations.

scholarly journals Visual Design and Anthropomorphism in a Mobile Pulmonary Rehabilitation Support Intervention

2021 ◽  
Author(s):  
Cindy Chong ◽  
Danielle Lottridge ◽  
Jim Warren ◽  
Rosie Dobson
Keyword(s):  
Pilot Study ◽  
Pulmonary Rehabilitation ◽  
Symptom Control ◽  
Exercise Program ◽  
Smartphone Application ◽  
Study Data ◽  
Text Messages ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Improve Symptom

Pulmonary rehabilitation is a behavioral intervention that can improve symptom control and quality of life for patients with chronic obstructive pulmonary disease (COPD), but access, uptake and adherence are problematic. Our team has pursued the development of a mobile phone-based intervention (mobile pulmonary rehabilitation, mPR) with iterative design and a pilot study. The mPR intervention is delivered through two technologies: text messages (SMS) and a smartphone application. Our user-centered design analysis of pilot study data led to several insights. First, patients’ replies to the SMS suggested that messages were anthropomorphised and provided social support. Second, the smartphone application could help patients by clearly visualizing the exercise program, alternative exercises, and progress to date. We demonstrate the design iterations made to meet these requirements and we present feedback obtained from experts and from four COPD patients. We discuss implications for the design of mobile pulmonary rehabilitation interventions.

scholarly journals Clinical difference between single subtype and mixed subtype chronic urticaria: A retrospective study

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Manyun Mao ◽  
Yan Yuan ◽  
Yangjian Xiao ◽  
Cong Peng ◽  
Xiang Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Urticaria ◽  
Symptom Control ◽  
Life Quality ◽  
Clinical Difference ◽  
Improve Symptom ◽  
Comprehensive Knowledge ◽  
Positive Rate ◽  
Common Group ◽  
Urticaria Activity Score

Background: The subtypes of chronic urticaria share a common clinical expression, but may show differences phenotypically. Meanwhile, two or more different subtypes of chronic urticaria can coexist in any given patient which may involve different phenotypes. Aims: The study aims to compare the two phenotypes in terms of demographics, clinical profile and treatment response. Methods: In this retrospective study, 2678 chronic urticaria patients were divided into the single subtype chronic urticaria group and mixed subtype chronic urticaria group as was appropriate.The differences in the clinical features, possible causes, urticaria activity score of seven days, dermatology life quality index score, laboratory investigations and response to treatments were evaluated among the two groups. Results: An obvious female predominance was detected in chronic urticaria, especially in mixed subtype chronic urticaria patients. Of the 2678 chronic urticaria patients, there were 837(31.25%) mixed subtype chronic urticaria. Chronic spontaneous urticaria combined with symptomatic dermographism was the most common group in the mixed subtype chronic urticaria. Patients with mixed subtype chronic urticaria were more likely to have associated chest tightness/shortness of breath and showed greater urticaria activity. In patients with single subtype chronic urticaria, the positive rate of family history with allergic rhinitis, asthma or urticaria was lower. Based on evaluation of the treatment, control with second-generation antihistamines at licensed doses was achieved in only 38.83% of mixed subtype chronic urticaria patients, compared with 56.32% of patients with single subtype. Limitations: First, this study was a single-center design retrospective study. Second, omalizumab treatment was not included. Third, the differences between different subtypes of mixed subtype chronic urticaria were not discussed in detail. Conclusion: This study showed that mixed subtype chronic urticaria had some distinct features. Comprehensive knowledge about it may help us define effective therapeutic strategies and improve symptom control and the quality of life for chronic urticaria patients.

scholarly journals Integration of palliative care into the neuro-oncology practice: patterns in the United States

2014 ◽  
Vol 1 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Tobias Walbert
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Brain Tumor ◽  
End Of Life ◽  
Symptom Control ◽  
Tumor Patients ◽  
Life Phase ◽  
Improve Symptom ◽  
Oncology Practice

Abstract Background Between 80%–85 percent of all adult brain tumors are high-grade gliomas (HGGs). Despite aggressive treatment with surgical resection, radiotherapy and chemotherapy, the survival of patients with HGG is limited. Brain tumor patients develop unique symptoms and needs throughout their disease trajectory, and the majority lose the ability to communicate during the end-of-life phase. Palliative care (PC) is a proactive and systematic approach to manage issues that are important to patients and families affected by serious illness. The goal is to improve quality of life and symptom control and thereby reduce suffering. Most PC interventions take place during the end-of-life phase; however, newer data suggest that early PC interventions might improve symptom control and quality of life. Methods A literature review focusing on PC, hospice care, and end-of-life care was performed with the aim to describe the integration of PC into neuro-oncology practice. Results Recently there has been increased interest in the effects of PC and brain tumor patients. The origins, methodology, and conceptual models of delivering PC and how it might be applied to the field of neuro-oncology were reviewed. Patterns of referral and utilization in neuro-oncology are described based on the findings of a recent survey. Conclusions Despite a very high symptom burden, many HGG patients do not receive the same level of PC and have fewer interactions with PC services than other cancer populations. Early PC interventions and structured advance-care planning might improve symptom control and quality of life for brain tumor patients.

Do hospital palliative care teams improve symptom control? Use of a modified STAS as an evaluation tool

1998 ◽  
Vol 12 (5) ◽  
pp. 345-351 ◽  
Author(s):  
Polly M Edmonds ◽  
Joanna M Stuttaford ◽  
Jane Penny ◽  
Anna Marie Lynch ◽  
Joe Chamberlain
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Evaluation Tool ◽  
Improve Symptom ◽  
Palliative Care Teams

scholarly journals The therapy of idiopathic pulmonary fibrosis: what is next?

2019 ◽  
Vol 28 (153) ◽  
pp. 190021 ◽  
Author(s):  
Vivien Somogyi ◽  
Nazia Chaudhuri ◽  
Sebastiano Emanuele Torrisi ◽  
Nicolas Kahn ◽  
Veronika Müller ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Symptom Control ◽  
Early Death ◽  
Clinical Diagnostics ◽  
Lung Function Decline ◽  
Clinical Phase ◽  
New Therapeutic Approaches ◽  
Improve Symptom ◽  
Acute Exacerbations

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease, characterised by progressive scarring of the lung and associated with a high burden of disease and early death. The pathophysiological understanding, clinical diagnostics and therapy of IPF have significantly evolved in recent years. While the recent introduction of the two antifibrotic drugs pirfenidone and nintedanib led to a significant reduction in lung function decline, there is still no cure for IPF; thus, new therapeutic approaches are needed. Currently, several clinical phase I–III trials are focusing on novel therapeutic targets. Furthermore, new approaches in nonpharmacological treatments in palliative care, pulmonary rehabilitation, lung transplantation, management of comorbidities and acute exacerbations aim to improve symptom control and quality of life. Here we summarise new therapeutic attempts and potential future approaches to treat this devastating disease.

scholarly journals Hypnosis in a specialist palliative care setting – enhancing personalized care for difficult symptoms and situations

2020 ◽  
Vol 14 ◽  
pp. 263235242095343
Author(s):  
Sara Booth
Keyword(s):  
Palliative Care ◽  
Care Setting ◽  
Symptom Control ◽  
Evidence Base ◽  
Self Management ◽  
Specialist Palliative Care ◽  
Personalized Care ◽  
Improve Symptom ◽  
Palliative Care Setting

This is a personal account of using hypnosis as an adjunct to specialist palliative care (SPC) treatment approaches. After a brief systematic review of the literature, one clinician’s experience is outlined illustrated by short, anonymized case histories. It argues that the approach is underused in SPC. The barriers currently restricting its routine adoption in SPC are discussed including (1) a lack of SPC clinical trials, (2) a misunderstanding of hypnosis leading to stigma, and (3) its absence from clinicians’ training pathways. While the evidence base for the effectiveness of hypnosis in ‘supportive care’, for example, managing chemotherapy-induced vomiting, is appreciable, there is a gap in SPC. There is little data to guide the use of hypnosis in the intractable symptoms of the dying, for example, breathlessness or the distress associated with missed or late diagnosis. There are many people now ‘living with and beyond cancer’ with chronic symptomatic illness, ‘treatable but not curable’. Patients often live with symptoms over a long period, which are only partially responsive to pharmacological and other therapies. Hypnosis may help improve symptom control and quality of life. SPC trials are needed so that this useful tool for self-management of difficult symptoms can be more widely adopted.

Combination therapy with relaxin and methylprednisolone augments the effects of either treatment alone in inhibiting subepithelial fibrosis in an experimental model of allergic airways disease

2012 ◽  
Vol 124 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Simon G. Royce ◽  
Amelia Sedjahtera ◽  
Chrishan S. Samuel ◽  
Mimi L. K. Tang
Keyword(s):  
Combination Therapy ◽  
Experimental Model ◽  
Murine Model ◽  
Symptom Control ◽  
Airway Remodelling ◽  
Novel Therapies ◽  
Collagen Deposition ◽  
Airway Reactivity ◽  
Improve Symptom ◽  
Subepithelial Fibrosis

Although CSs (corticosteroids) demonstrate potent effects in the control of airway inflammation in asthma, many patients continue to experience symptoms and AHR (airway hyper-responsiveness) despite optimal treatment with these agents, probably due to progressive airway remodelling. Identifying novel therapies that can target airway remodelling and/or airway reactivity may improve symptom control in these patients. We have demonstrated previously that the anti-fibrotic hormone RLN (relaxin) can reverse airway remodelling (epithelial thickening and subepithelial fibrosis) and AHR in a murine model of AAD (allergic airways disease). In the present study, we compared the effects of RLN with a CS (methylprednisolone) on airway remodelling and AHR when administered independently or in combination in the mouse AAD model. Female mice at 6–8 weeks of age were sensitized and challenged to OVA (ovalbumin) over a 9-week period and treated with methylprednisolone, RLN, a combination of both treatments or vehicle controls. Methylprednisolone was administered intraperitoneally on the same day as nebulization for 6 weeks, whereas recombinant human RLN-2 was administered via subcutaneously implanted osmotic mini-pumps from weeks 9–11. RLN or methylprednisolone alone were both able to significantly decrease subepithelial thickness and total lung collagen deposition; whereas RLN but not methylprednisolone significantly decreased epithelial thickness and AHR. Additionally, combination therapy with CS and RLN more effectively reduced subepithelial collagen thickness than either therapy alone. These findings demonstrate that RLN can modulate a broader range of airway remodelling changes and AHR than methylprednisolone and the combination of both treatments offers enhanced control of subepithelial fibrosis.

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