Effect of video angle on detection of induced front limb lameness in horses.

Background: Lameness examinations are commonly performed in equine medicine. Advancements in digital technology have increased the use of video recordings for lameness assessment, however, standardization of ideal video angle is not available yielding videos of poor diagnostic quality. The objective of this study was to evaluate the effect of video angle on the subjective assessment of front limb lameness.

Insomnia in patients with advanced lung cancer admitted to palliative care services.

Aim: To assess the prevalence of insomnia and possible associated factors in patients with advanced lung cancer admitted to different settings of palliative care.

Methods: Secondary analysis of a consecutive sample of patients with advanced lung cancer receiving palliative care. Epidemiological and clinical data, treatments received in the last month, Karnofsky status, Edmonton Symptom Assessment System (ESAS), Athens Insomnia Scale and the Hospital Anxiety and Depression Scale (HADS), as well as concomitant medical treatment were recorded.

Breakthrough Cancer Pain Clinical Features and Differential Opioids Response: A Machine Learning Approach in Patients With Cancer From the IOPS-MS Study.

Purpose: A large proportion of patients with cancer suffer from breakthrough cancer pain (BTcP). Several unmet clinical needs concerning BTcP treatment, such as optimal opioid dosages, are being investigated. In this analysis the hypothesis, we explore with an unsupervised learning algorithm whether distinct subtypes of BTcP exist and whether they can provide new insights into clinical practice.

[Overview and symptom management in heart failure patients eligible for palliative care].

Burden symptom in advanced heart failure highly affects quality of life of both patients and caregivers, leading to severe functional limitation and social isolation. Symptoms in the advanced phases of the disease are numerous and often underestimated and undertreated. This negatively affects not only quality of life, but also increases hospitalizations, reduces therapeutic adherence, impairs cardiac function and leads to reduced survival.

[Palliative care and heart failure: some remarks about cost-effectiveness and clinical results].

Early palliative care (PC) clearly demonstrated its efficacy in patients with heart failure (HF), reducing symptom burden, mainly pain and depression, improving quality of life, and reducing the access to the health care system. However, there are not conclusive data on economic cost reduction. The reasons are related to the few patients involved in the studies dedicated to this topic, to the different clinical settings, different modalities of provision and funding of PC, and different timing of PC implementation.

Translation and cognitive testing of the Italian Integrated Palliative Outcome Scale (IPOS) among patients and healthcare professionals.

Background: Outcome measurement is fundamental to assess needs and priority of care in palliative care settings. The Integrated Palliative care Outcome Scale (IPOS) was developed from earlier versions of this tool. Its use is encouraged to ameliorate the assessment of individual outcomes in palliative care settings.

Factors Influencing the Clinical Presentation of Breakthrough Pain in Cancer Patients.

The aim of this study was to identify potential variables influencing the clinical presentation of breakthrough cancer pain (BTP). Cancer patients with a diagnosis of BTP were enrolled. Demographic and clinical characteristics, as well as background pain and BTP characteristics were collected.

Breakthrough Cancer Pain: Preliminary Data of The Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS).

Introduction: An ongoing national multicenter survey [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] is evaluating the characteristics of breakthrough cancer pain (BTP) in different clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here.

Methods: Thirty-two clinical centers are involved in the survey.

Validity, reliability and responsiveness to change of the Italian palliative care outcome scale: a multicenter study of advanced cancer patients.

Background: There is an increasing requirement to assess outcomes, but few measures have been tested for advanced medical illness. We aimed to test the validity, reliability and responsiveness of the Palliative care Outcome Scale (POS), and to analyse predictors of change after the transition to palliative care.

Methods: Phase 1: multicentre, mixed method study comprising cognitive and qualitative interviews with patients and staff, cultural refinement and adaption.

Epidemiology and Characteristics of Episodic Breathlessness in Advanced Cancer Patients: An Observational Study.

Context: Episodic breathlessness is a relevant aspect in patients with advanced cancer.

Objectives: The aim of this study was to assess the different aspects of this clinical phenomenon.

Methods: A consecutive sample of patients with advanced cancer admitted to different settings for a period of six months was surveyed.

Sleep Disturbances in Patients With Advanced Cancer in Different Palliative Care Settings.

Context: Information regarding sleep disturbances in the population with advanced cancer is meager.

Objectives: To assess the prevalence of sleep disturbances and possible correlations with associated factors in a large number of patients with advanced cancer admitted to different palliative care settings.

Methods: This was an observational study performed in different settings of palliative care.

Prevalence of oral mucositis, dry mouth, and dysphagia in advanced cancer patients.

Background: Oral symptoms can be a sign of an underlying systemic condition and have a significant impact on quality of life, nutrition, and cost of care, while these lesions are often studied in the context of cancer treatment. However, information regarding oral symptoms in advanced cancer patients is poor. The aim of this multicenter study was to determine the prevalence and the characteristics of oral symptoms in a large population of advanced cancer patients.

Italian Oncological Pain Survey (IOPS): a multicentre Italian study of breakthrough pain performed in different settings.

Objective: A survey of breakthrough pain (BTP) was performed in five palliative care units (PCU), seven oncology departments (ONC), and nine pain clinics (OPC).

Methods: A standard algorithm was used to confirm the diagnosis of BTP of patients refereed to different settings.

Results: 1,412 evaluable cancer patients were enrolled.

Long-term efficacy and tolerability of intranasal fentanyl in the treatment of breakthrough cancer pain.

Purpose: The aim of the present study was to assess the long-term tolerability and efficacy of intranasal fentanyl (INFS) in opioid-tolerant patients with breakthrough cancer pain (BTP).

Patients And Methods: A 6 months, observational, prospective, cohort study design was employed to follow advanced cancer patients with BTP receiving INFS under routine clinical practice. Eligible adult cancer patients suffering from BTP had been prescribed INFS at effective doses.

The last months of life of people with amyotrophic lateral sclerosis in mechanical invasive ventilation: a qualitative study.

In Italy 10-30% of patients who die with amyotrophic lateral sclerosis are invasively ventilated. It is difficult to predict when patients will die and when a specialist palliative care service may effectively be involved. Nineteen semi-structured interviews with informal family carers who looked after these patients who had died in last 10 years were undertaken to ascertain their experiences in the final stages of the disease.

Orphan symptoms in advanced cancer patients followed at home.

Orphan symptoms are rarely assessed, particularly at home. The aim of this multicenter prospective study was to assess the prevalence of these symptoms and eventual factors possibly associated in advanced cancer patients at admission of a home care program. A prospective study was performed at three home care programs in Italy.

Palliative sedation in patients with advanced cancer followed at home: a prospective study.

Context: Home care programs in Italy.

Objectives: The aim of this study was to assess a protocol for palliative sedation (PS) performed at home.

Methods: A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities.

Relationship between background cancer pain, breakthrough pain, and analgesic treatment: a preliminary study for a better interpretation of epidemiological and clinical studies.

Background: The different operational definitions of breakthrough cancer pain (BTcP) has generated unclear epidemiological data.

Methods: A consecutive sample of patients was categorized on the basis of their background pain intensity, background analgesic treatment, and the presence of BTcP.

Results: A total of 265 patients were surveyed; 117 patients had background pain and 91 patients presented peaks of pain intensity distinguishable from background pain.

The poor use of methadone in Italian hospices.

Purpose: A hospice may provide an ideal setting to use methadone because of a more protective environment in comparison with a home care setting, where it is seldom used. The aim of this survey was to investigate the frequency of the use of methadone in Italian hospices and how it is used.

Methods: The Italian registry of palliative care institutions, named Osservatorio Federazione cure palliative, was consulted at its official website.

Opioid switching in patients with advanced cancer followed at home. A retrospective analysis.

Context: Opioid switching has been found to improve opioid responsiveness in different conditions. However, data on opioid switching performed at home are almost nonexistent, despite the fact that most patients are followed at home.

Objectives: The aim of this retrospective survey was to determine frequency, indications, usefulness, and safety of opioid switching when treating advanced cancer-related pain in patients followed at home.

Pattern and characteristics of advanced cancer patients admitted to hospices in Italy.

The aim of this multicenter study was to assess the pattern and the characteristics of advanced cancer patients admitted to hospices. A consecutive sample of patients admitted in a period of 6 months was taken into consideration. Two hundred thirty-six patients admitted to hospices were consecutively assessed.

Prognostic factors of survival in patients with advanced cancer admitted to home care.

Context: Data regarding prognostication of life expectancy in patients with advanced cancer are of paramount importance to patients, families, and clinicians. However, data regarding patients followed at home are lacking.

Objectives: The aim of this study was to evaluate the correlation between various factors recorded at the beginning of home care assistance and survival.

Emergencies in patients with advanced cancer followed at home.

Context: Patients with advanced cancer stay at home for most of their time, and acute problems may occur during home care. Caregivers may call medical services for an emergency, which can result in patients being admitted to the hospital. No data exist on emergencies in patients followed by a home care team.

Palliative sedation in advanced cancer patients followed at home: a retrospective analysis.

Context: Data regarding palliative sedation at home in dying patients are lacking.

Objectives: To describe the frequency, indication, and modality of palliative sedation (PS) in patients followed at home.

Methods: A retrospective analysis of home care cancer patients was performed.

[Project "Hospital without pain": analysis of the Italian situation before the law 38].

Project "Hospital without pain": analysis of the Italian situation before the law 38. Background. Some years ago, the project "Pain free Hospital" started in Italy to improve standards of pain management.