Refractory Cancer Pain and Intrathecal Therapy: Critical Review of a Systematic Review.

This critical review assessed the advantages of invasive procedures that were recently included in systematic reviews, to evaluate whether the definition of refractory pain condition was correctly followed to select patients for invasive interventions and to analyze how data were positively interpreted. A total of 21 studies were selected for the purpose of this review. Three were randomized controlled studies, ten were prospective studies, and eight were retrospective studies.

Breakthrough cancer pain in the radiotherapy setting: a systematic and critical review.

Introduction: Breakthrough pain (BP) is a complex phenomenon that has been reported to have a relevant role in the global management of cancer pain. Radiotherapy (RT) has a fundamental part in the treatment of many pain conditions, particularly oral mucositis and painful bone metastases.

Areas Covered: The literature regarding the phenomenon of BP in the radiotherapy setting was reviewed.

Characteristics of Untreated Cancer Patients Admitted to an Acute Supportive/Palliative Care Unit.

Backgrund: The characteristics of patients who had never received anticancer treatments at admission of an acute supportive palliative care unit (ASPCU) have never been explored.

Measures: From a consecutive sample of 422 advanced cancer patients, 62 patients with no previous anticancer therapy were selected and compared with a random sample of patients who had received anticancer treatments. Age, gender, primary tumor, Karnofsky status, characteristics of admission, the level of education, economic status, awareness of disease, the presence of cachexia, and comorbidities and palliative prognostic score, symptom intensity, opioid drugs used at admission, reasons for admission to APSCU were recorded in both groups.

Acute palliative care units: characteristics, activities and outcomes - scoping review.

Acute palliative care units (APCUs) are lacking in most cancer hospitals and even when palliative care units are present, they are predominantly based on a traditional hospice-like model for patients with short life expectancy. This scoping review examined the papers assessing the activities of APCU. Data from literature regarding APCU characteristics, activities and outcomes have shown important differences among different countries.

Conversion ratios for opioid switching: a pragmatic study.

Background: The final conversion ratios among opioids used for successful switching are unknown. The aim of this study was to determine the initial and final conversion ratios used for a successful opioid switching in cancer patients, and eventual associated factors.

Methods: Ninety-five patients who were successfully switched were evaluated.

Rapid Titration With Intravenous Oxycodone for Severe Cancer Pain and Oral Conversion Ratio.

Context: to assess a dose titration with intravenous oxycodone to achieve rapid pain relief of cancer pain of severe intensity. The second objective was to provide a conversion ratio with the oral route.

Methods: Cancer patients admitted for severe pain were prospectively assessed.

The Paradigm Shift from End of Life to Pre-Emptive Palliative Care in Patients with Cancer.

In most countries, health care providers have circumscribed palliative care in a network represented by home care and hospice care [...

Pediatric Consultation-Liaison Psychology: Insights and Lessons Learned During the COVID-19 Pandemic.

COVID-19 has presented a variety of challenges to the provision of psychology services. In the first month of the pandemic, pediatric consultation-liaison (CL) psychologists reported significant changes in methodology of service delivery (Steinberg et al. in Clin Pract Pediatr Psychol 9:1, 2020).

Commentary: Interpreting Data of Celiac Plexus Block in Patients with Pancreatic Pain: Timing, Patients, Survival.

Although celiac plexus block (CPB) is a well known technique that has been performed for years, only in the last 30 years controlled studies, demonstrated its efficacy and safety. A historical pathway of literature regarding CPB and a critical analysis may help understand some points which remain still controversial, for a better interpretation of data.

Maddalena Opioid Switching Score in patients with cancer pain.

Evaluation of opioid switching (OS) for cancer pain has not been properly assessed. The aim of this study was to assess an integrated score (Maddalena Opioid Switching Score) as a simple and repeatable tool to evaluate the outcomes of OS, facilitating the interpretation and comparison of studies, and information exchange among researchers. The integrated score took into account pain intensity, intensity of opioid-related symptoms, and cognitive function by using an author's formula.

Constipation in Cancer Patients - an Update of Clinical Evidence.

Constipation is one of the most frequent problems in cancer patients, and its etiology is multifactorial. It leads to decreased quality of life and impedes optimal pain treatment. Despite the high prevalence, constipation is frequently underdiagnosed mainly because of lack of validated diagnostic criteria or widely accepted definition of constipation in cancer patients.

Methadone as First-line Opioid for the Management of Cancer Pain.

Aim: The aim of this study was to assess the efficacy and adverse effects of methadone when used as first-line therapy in patients that are either receiving low doses of opioids or none.

Methods: Patients with advanced cancer were prospectively assessed. Opioid-naive patients (L-group) were started with methadone at 6 mg/day.

Caregiver Distress in Home Palliative Care.

This study aims to determine the symptom burden of caregivers who were following their loved ones at home and factors associated with this burden. From a consecutive number of patients followed at home by a specialistic palliative care team, a sample of 46 was screened. Epidemiological data of both patients and caregivers were collected, also including some variables, such as the level of religiousness, education, economic conditions, and financial distress.

Pattern and characteristics of patients admitted to a hospice connected with an acute palliative care unit in a comprehensive cancer center.

Purpose: Information about inpatient hospice activity is limited. No data exist about the pattern and the characteristics of advanced cancer patients admitted to a hospice connected to an acute supportive/palliative care unit (ASPCU).

Methods: Data of hospice admissions were retrieved from the database where all data were prospectively collected.

High flow nasal therapy in the management of hypoxemic dyspnea at the end of life.

Refractory dyspnea is challenging for physicians treating patients near to the end of life. High-flow nasal therapy (HFNT). We report a case in which HFNS was effective in a patient in the last days of life to mitigate dyspnea allowing a minimal quality of life for some days before dying.

The Prevalence and Characteristics of Breakthrough Cancer Pain in Patients Receiving Low Doses of Opioids for Background Pain.

The aim of this study was to assess the prevalence and characteristics of breakthrough cancer pain (BTcP) in patients receiving low doses of opioids for background pain. A consecutive sample of advanced cancer patients receiving less than 60 mg/day of oral morphine equivalent (OME) was selected. Epidemiological data, background pain intensity, and current analgesic therapy were recorded.

Persistent Spinal Pain Syndrome: A Proposal for Failed Back Surgery Syndrome and ICD-11.

Objective: For many medical professionals dealing with patients with persistent pain following spine surgery, the term Failed back surgery syndrome (FBSS) as a diagnostic label is inadequate, misleading, and potentially troublesome. It misrepresents causation. Alternative terms have been suggested, but none has replaced FBSS.

Aberrant opioid use behaviour in advanced cancer.

Objectives: To evaluate the presence of aberrant behaviour in a consecutive sample of patients with advanced cancer treated with opioids in a country like Italy, with its peculiar attitudes towards the use opioids. The second objective was to detect the real misuse of opioids in clinical practice.

Methods: Prospective observational study in two palliative care units in Italy in a period of 6 months.

Barriers and Adherence to Pain Management in Advanced Cancer Patients.

Aim: To assess patients' barriers to pain management and analgesic medication adherence in patients with advanced cancer.

Methods: This was a prospective cross-sectional study in patients with advanced cancer receiving chronic opioid therapy. Age, gender, cancer diagnosis, Karnofsky level, and educational status were recorded.