BOOK
Palliative Medicine E-Book
T. Declan Walsh | Augusto T. Caraceni | Robin Fainsinger | Kathleen M. Foley | Paul Glare | Cynthia Goh | Mari Lloyd-Williams | Juan Nunez Olarte | Lukas Radbruch
(2008)
Additional Information
Book Details
Abstract
As a palliative medicine physician, you struggle every day to make your patients as comfortable as possible in the face of physically and psychologically devastating circumstances. This new reference equips you with all of today's best international approaches for meeting these complex and multifaceted challenges. In print and online, it brings you the world's most comprehensive, state-of-the-art coverage of your field. You'll find the answers to the most difficult questions you face every day...so you can provide every patient with the relief they need.
- Equips you to provide today's most effective palliation for terminal malignant diseases • end-stage renal, cardiovascular, respiratory, and liver disorders • progressive neurological conditions • and HIV/AIDS.
- Covers your complete range of clinical challenges with in-depth discussions of patient evaluation and outcome assessment • ethical issues • communication • cultural and psychosocial issues • research in palliative medicine • principles of drug use • symptom control • nutrition • disease-modifying palliation • rehabilitation • and special interventions.
- Helps you implement unparalleled expertise and global best practices with advice from a matchless international author team.
- Provides in-depth guidance on meeting the specific needs of pediatric and geriatric patients.
- Assists you in skillfully navigating professional issues in palliative medicine such as education and training • administration • and the role of allied health professionals.
- Includes just enough pathophysiology so you can understand the "whys" of effective decision making, as well as the "how tos."
- Offers a user-friendly, full-color layout for ease of reference, including color-coded topic areas, mini chapter outlines, decision trees, and treatment algorithms.
- Comes with access to the complete contents of the book online, for convenient, rapid consultation from any computer.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | Cover | ||
| PALLIATIVE MEDICINE | iii | ||
| Copyright page | iv | ||
| PREFACE | vii | ||
| INTERNATIONAL ADVISORY BOARD | ix | ||
| CONTRIBUTORS | xi | ||
| Table of contents | xxxiii | ||
| PART I: Principles | 1 | ||
| SECTION A: Palliative Medicine | 2 | ||
| CHAPTER 1: Palliative Medicine—The Global Perspective: Closing the Know-Do Gap | 2 | ||
| THE NEED FOR PALLIATIVE CARE | 2 | ||
| ACTION: ESTABLISHING A NATIONAL PALLIATIVE CARE PROGRAM | 3 | ||
| PALLIATIVE CARE FOR ALL: THE COMMUNITY APPROACH | 6 | ||
| REFERENCES | 7 | ||
| SUGGESTED READING | 7 | ||
| CHAPTER 2: Death in Modern Society | 8 | ||
| DEMOGRAPHICS AND CAUSES OF DEATH IN MODERN SOCIETIES | 8 | ||
| CONCLUSIONS | 12 | ||
| REFERENCES | 12 | ||
| SUGGESTED READING | 13 | ||
| CHAPTER 3: Illness Trajectories and Stages* | 13 | ||
| DIFFERENT TRAJECTORIES FOR DIFFERENT DISEASES | 13 | ||
| CLINICAL IMPLICATIONS | 15 | ||
| IMPLICATIONS FOR SERVICE PLANNING AND DEVELOPMENT | 17 | ||
| CONCLUSIONS | 17 | ||
| ACKNOWLEDGMENTS | 17 | ||
| REFERENCES | 17 | ||
| SUGGESTED READING | 18 | ||
| ADDITIONAL RESOURCES | 18 | ||
| CHAPTER 4: The History of Hospice | 18 | ||
| BACKGROUND | 18 | ||
| HISTORY | 18 | ||
| THE LEGISLATIVE ROLE IN HOSPICE AND PALLIATIVE CARE | 20 | ||
| PHILOSOPHY OF HOSPICE | 21 | ||
| HOSPICE TODAY | 21 | ||
| CHALLENGES FOR THE FUTURE | 22 | ||
| REFERENCES | 22 | ||
| SUGGESTED READING | 23 | ||
| CHAPTER 5: Palliative Medicine: Models of Organization | 23 | ||
| ORGANIZATIONAL DEFINITIONS | 23 | ||
| QUALITY | 23 | ||
| DIMENSIONS AND ACTIVITIES OF PALLIATIVE MEDICINE | 24 | ||
| BASIC PALLIATIVE MEDICINE | 24 | ||
| SPECIALIST PALLIATIVE MEDICINE | 24 | ||
| TYPES AND LOCATION OF PALLIATIVE MEDICINE SERVICES | 26 | ||
| OUTCOMES | 27 | ||
| EVALUATION AND QUALITY IMPROVEMENT | 28 | ||
| DEVELOPMENT TRENDS | 28 | ||
| REFERENCES | 28 | ||
| CHAPTER 6: The Specialty of Palliative Medicine | 29 | ||
| DEFINITION OF A MEDICAL SPECIALTY OR MEDICAL EXPERT | 29 | ||
| PALLIATIVE MEDICINE SPECIALISTS | 29 | ||
| DEVELOPMENT OF THE SPECIALTY OF PALLIATIVE MEDICINE | 29 | ||
| CORE COMPETENCIES OF PALLIATIVE MEDICINE PHYSICIANS | 30 | ||
| CHALLENGES FOR PALLIATIVE MEDICINE | 32 | ||
| PALLIATIVE MEDICINE TRAINING PROGRAMS | 32 | ||
| CONCLUSIONS | 33 | ||
| REFERENCES | 33 | ||
| CHAPTER 7: Principles of Palliative Medicine | 33 | ||
| THE PURPOSE AND FORMATION OF PRINCIPLES | 33 | ||
| PRINCIPLES OF THE SPECIALTY OF HOSPICE AND PALLIATIVE CARE | 35 | ||
| OPERATIONAL PRINCIPLES | 39 | ||
| CONCLUSIONS | 40 | ||
| REFERENCES | 40 | ||
| SUGGESTED READING | 41 | ||
| SECTION B: Psychosocial Care | 42 | ||
| CHAPTER 8: The Human Experience of Illness | 42 | ||
| WHAT IS ILLNESS? | 42 | ||
| TOWARD AN ADEQUATE VIEW OF PERSON | 42 | ||
| A NOTE ON PERSONAL DEVELOPMENT | 43 | ||
| THE “SEASONS OF ILLNESS” | 43 | ||
| PSYCHOLOGICAL RESPONSES TO ILLNESS | 44 | ||
| CONCLUSION | 45 | ||
| REFERENCES | 46 | ||
| CHAPTER 9: Suffering | 46 | ||
| SUFFERING VERSUS PAIN | 47 | ||
| CONSTANT FEATURES OF SUFFERING AND A DEFINITION | 47 | ||
| SUFFERING IS PERSONAL | 47 | ||
| WHAT IS INTEGRITY, AND WHAT IS INTACTNESS? | 48 | ||
| ALL SUFFERING IS UNIQUE AND INDIVIDUAL | 48 | ||
| RECOGNIZING SUFFERING | 49 | ||
| TREATING SUFFERING | 50 | ||
| IS SUFFERING PSYCHIATRIC PATHOLOGY? | 51 | ||
| REFERENCES | 51 | ||
| SUGGESTED READING | 51 | ||
| CHAPTER 10: Culture, Ethnicity, and Illness | 51 | ||
| ETHNICITY AND ACCESS | 52 | ||
| PATIENT AUTONOMY AND FAMILY DECISION MAKING | 52 | ||
| THE SANCTITY OF LIFE AND EUTHANASIA | 52 | ||
| ALTERNATIVE CONCEPTS OF ILLNESS AND DYING | 52 | ||
| CULTURAL AND RELIGIOUS DIVERSITY | 53 | ||
| RELIGIOUS NEEDS IN ADVANCED DISEASE | 53 | ||
| CONCLUSIONS | 54 | ||
| REFERENCES | 55 | ||
| CHAPTER 11: The Desire for Death | 55 | ||
| PREVALENCE | 56 | ||
| COMMON RISK FACTORS | 56 | ||
| LEGAL AND ETHICAL ISSUES IN ASSISTED SUICIDE | 56 | ||
| ASSESSMENT | 57 | ||
| INTERVENTIONS | 57 | ||
| PROPOSED PRACTICE GUIDELINES | 57 | ||
| RESEARCH CHALLENGES AND OPPORTUNITIES | 58 | ||
| REFERENCES | 58 | ||
| SUGGESTED READING | 59 | ||
| CHAPTER 12: Spiritual Distress | 59 | ||
| DEFINING SPIRITUALITY AND SPIRITUAL DISTRESS | 60 | ||
| SPIRITUAL DISTRESS AND BELIEF SYSTEMS | 61 | ||
| INTERVENTIONS | 61 | ||
| RESEARCH AND SPIRITUALITY | 62 | ||
| CONCLUSIONS | 62 | ||
| REFERENCES | 63 | ||
| SUGGESTED READING | 63 | ||
| CHAPTER 13: Families in Distress | 63 | ||
| WHO IS THE FAMILY? | 63 | ||
| ASSESSING FAMILIES IN DISTRESS | 64 | ||
| THE NEED FOR INFORMATION: MAINTAINING TRUST | 66 | ||
| FAMILY CONFLICT: ESTRANGEMENT AND REUNIFICATION | 67 | ||
| THE INFLUENCE OF THE TEAM | 68 | ||
| CONCLUSIONS | 68 | ||
| REFERENCES | 68 | ||
| SUGGESTED READING | 69 | ||
| CHAPTER 14: Grief and Bereavement | 69 | ||
| THEORETICAL MODELS OF GRIEF | 69 | ||
| CLINICAL PRESENTATIONS OF GRIEF | 71 | ||
| A FAMILY APPROACH TO BEREAVEMENT CARE | 73 | ||
| EVIDENCE-BASED MEDICINE | 73 | ||
| RESEARCH CHALLENGES | 74 | ||
| CONCLUSION | 74 | ||
| REFERENCES | 75 | ||
| SUGGESTED READING | 75 | ||
| CHAPTER 15: Stress and Burnout | 75 | ||
| DEFINITIONS | 75 | ||
| STRESS, DEPRESSION, AND BURNOUT | 76 | ||
| A MODEL FOR UNDERSTANDING OCCUPATIONAL STRESS | 77 | ||
| JOB SATISFACTION, JOB ENGAGEMENT, AND COMPASSION SATISFACTION | 77 | ||
| THE IMPACT OF RELIGION AND SPIRITUALITY ON BURNOUT | 78 | ||
| EVIDENCE-BASED INTERVENTIONS | 81 | ||
| CONCLUSIONS | 82 | ||
| REFERENCES | 82 | ||
| CHAPTER 16: Body Image and Sexuality | 83 | ||
| COMMON DISEASES THAT AFFECT BODY IMAGE AND SEXUALITY | 83 | ||
| DRUGS COMMONLY USED IN PALLIATIVE MEDICINE WITH EFFECTS ON SEXUALITY AND SEXUAL FUNCTION | 85 | ||
| SEXUAL HISTORY | 85 | ||
| CONCLUSIONS | 86 | ||
| REFERENCES | 86 | ||
| SUGGESTED READING | 87 | ||
| ADDITIONAL RESOURCES | 87 | ||
| SECTION C: Bioethics | 88 | ||
| CHAPTER 17: Principles of Bioethics | 88 | ||
| HISTORY OF BIOETHICS | 88 | ||
| THEORIES OF BIOETHICS | 89 | ||
| DECISION MAKING | 91 | ||
| CONCLUSION | 93 | ||
| REFERENCES | 93 | ||
| SUGGESTED READING | 93 | ||
| CHAPTER 18: Ethics and Clinical Practice | 94 | ||
| THE PRINCIPLE OF NONMALEFICENCE OR TECHNICAL CORRECTION | 95 | ||
| THE PATIENT AND THE EXPRESSION OF AUTONOMY | 97 | ||
| CONCLUSIONS | 98 | ||
| REFERENCES | 98 | ||
| CHAPTER 19: Advanced Directives | 98 | ||
| DEFINITION OF ADVANCE CARE PLANNING | 99 | ||
| HISTORY AND RATIONALE | 99 | ||
| ESSENTIAL ELEMENTS OF ADVANCE CARE PLANNING | 100 | ||
| BARRIERS THAT IMPEDE ADVANCE CARE PLANNING | 100 | ||
| RECENT DEVELOPMENTS | 101 | ||
| EVIDENCE BASE | 102 | ||
| CHALLENGES TO ADVANCE CARE PLANNING | 102 | ||
| FUTURE RESEARCH | 102 | ||
| CONCLUSIONS | 103 | ||
| REFERENCES | 103 | ||
| ADDITIONAL RESOURCES | 103 | ||
| CHAPTER 20: Withholding and Withdrawing Treatment | 104 | ||
| CURRENT STATUS OF WITHHOLDING AND WITHDRAWING TREATMENT | 104 | ||
| ETHICAL CONSENSUS ON WITHHOLDING AND WITHDRAWING TREATMENT | 104 | ||
| LEGAL CONSENSUS ON WITHHOLDING AND WITHDRAWING TREATMENT | 105 | ||
| RELIGIOUS IMPACT ON WITHHOLDING AND WITHDRAWING TREATMENT | 106 | ||
| DISCUSSING THE WITHHOLDING AND WITHDRAWING OF TREATMENT WITH PATIENTS AND THEIR FAMILIES | 107 | ||
| IMPLANTABLE CARDIAC DEFIBRILLATORS | 108 | ||
| CONCLUSIONS | 109 | ||
| REFERENCES | 109 | ||
| CHAPTER 21: Euthanasia and Physician-Assisted Suicide | 110 | ||
| DEFINING EUTHANASIA | 110 | ||
| LEGAL SITUATION | 111 | ||
| PUBLIC OPINION | 111 | ||
| FOUR ASSUMPTIONS | 112 | ||
| WORLD RELIGIONS AND EUTHANASIA | 113 | ||
| SLOW EUTHANASIA? | 113 | ||
| DEALING WITH REQUESTS FOR EUTHANASIA OR PHYSICIAN-ASSISTED SUICIDE | 114 | ||
| CONCLUSION: A PALLIATIVE FILTER | 115 | ||
| REFERENCES | 115 | ||
| SUGGESTED READING | 115 | ||
| CHAPTER 22: Research Bioethics | 115 | ||
| RESEARCH ETHICS CODES | 116 | ||
| INFORMED CONSENT FOR RESEARCH | 117 | ||
| EQUIPOISE | 117 | ||
| PLACEBOS | 117 | ||
| JUSTICE | 117 | ||
| CONCLUSIONS | 118 | ||
| SUGGESTED READING | 118 | ||
| REFERENCES | 118 | ||
| SECTION D: Education | 119 | ||
| CHAPTER 23: Curriculum Development | 119 | ||
| CURRICULUM DEVELOPMENT: GENERAL CONSIDERATIONS | 119 | ||
| CONTENT AND PROCESS ISSUES IN A PALLIATIVE CARE CURRICULUM | 119 | ||
| RECENT DEVELOPMENTS | 124 | ||
| CONCLUSIONS | 124 | ||
| REFERENCES | 124 | ||
| SUGGESTED READING | 125 | ||
| CHAPTER 24: Adult Learning | 125 | ||
| ADULT LEARNING THEORY | 125 | ||
| LEARNING THEORIES | 126 | ||
| EMERGING CONCEPTS AND FRAMEWORKS IN ADULT LEARNING | 128 | ||
| DETERMINANTS OF LEARNING | 130 | ||
| COMPETENCY AND ADULT LEARNING | 130 | ||
| ASSESSMENT AND EVALUATION OF LEARNING IN MEDICINE | 130 | ||
| CONCLUSIONS | 130 | ||
| REFERENCES | 131 | ||
| SUGGESTED READING | 131 | ||
| CHAPTER 25: Web-Based Learning | 131 | ||
| KEY CONCEPTS AND TOOLS | 132 | ||
| INSTRUCTIONAL DESIGN CONSIDERATIONS | 133 | ||
| EFFECTIVENESS OF WEB-BASED LEARNING | 134 | ||
| CONCLUSIONS | 135 | ||
| REFERENCES | 135 | ||
| SUGGESTED READING | 135 | ||
| ADDITIONAL RESOURCES | 135 | ||
| SECTION E: Research | 136 | ||
| CHAPTER 26: Principles of Palliative Medicine Research | 136 | ||
| EVIDENCE-BASED MEDICINE | 136 | ||
| GENERAL PRINCIPLES OF RESEARCH | 139 | ||
| ARGUMENTS AGAINST RESEARCH IN PALLIATIVE CARE | 140 | ||
| ARGUMENTS FOR RESEARCH IN PALLIATIVE CARE | 140 | ||
| PROBLEMS WITH RANDOMIZATION IN PALLIATIVE CARE RESEARCH | 141 | ||
| PROBLEMS IN PALLIATIVE CARE RESEARCH | 141 | ||
| IS RESEARCH IMPOSSIBLE IN PALLIATIVE CARE? | 142 | ||
| FACILITATING RESEARCH IN PALLIATIVE CARE | 142 | ||
| PATIENTS’ VIEWS ON PARTICIPATING IN RESEARCH | 142 | ||
| CONCLUSIONS | 142 | ||
| REFERENCES | 143 | ||
| CHAPTER 27: Developing a Research Group | 144 | ||
| MENTORSHIP | 144 | ||
| RESEARCH GROUP DEVELOPMENT | 144 | ||
| COLLABORATIVE RESEARCH: BENEFITS, BARRIERS, AND CHALLENGES | 146 | ||
| CONCLUSIONS | 146 | ||
| REFERENCES | 147 | ||
| SUGGESTED READING | 147 | ||
| ADDITIONAL SOURCES | 147 | ||
| CHAPTER 28: Design and Conduct of Research and Clinical Trials | 148 | ||
| THE CHALLENGE OF EVIDENCE | 148 | ||
| THE RESEARCH QUESTION | 149 | ||
| THE TRIAL DESIGN | 149 | ||
| ISSUES OF PRAGMATISM AND COMPLEXITY | 153 | ||
| CONCLUSIONS ABOUT WHAT MAKES A CLINICAL TRIAL WORK | 154 | ||
| REFERENCES | 155 | ||
| SUGGESTED READING | 156 | ||
| CHAPTER 29: Biostatistics and Epidemiology | 156 | ||
| STUDY DESIGNS | 156 | ||
| VARIABLE TYPES | 157 | ||
| UNIVARIABLE AND MULTIVARIABLE ANALYSIS | 157 | ||
| DATA COLLECTION AND CLEANING | 159 | ||
| STEPS IN CONDUCTING A RESEARCH STUDY | 160 | ||
| CONCLUSIONS | 160 | ||
| REFERENCES | 160 | ||
| SUGGESTED READING | 161 | ||
| CHAPTER 30: Symptom Research | 161 | ||
| RESEARCH IN SYMPTOM ASSESSMENT | 161 | ||
| RESEARCH IN SYMPTOM MANAGEMENT | 163 | ||
| CONCLUSIONS | 165 | ||
| REFERENCES | 165 | ||
| SUGGESTED READING | 165 | ||
| CHAPTER 31: Health Services Research | 165 | ||
| NEEDS ASSESSMENT | 166 | ||
| EVALUATION OF SERVICES AND INTERVENTIONS | 166 | ||
| DEVELOPMENTS IN PALLIATIVE CARE RESEARCH | 169 | ||
| CONCLUSIONS AND FUTURE CHALLENGES | 169 | ||
| REFERENCES | 169 | ||
| SUGGESTED READING | 170 | ||
| CHAPTER 32: Psychosocial Research | 170 | ||
| SURVEYS | 171 | ||
| OBSERVATIONAL STUDIES | 171 | ||
| CONTROLLED CLINICAL TRIALS | 172 | ||
| QUALITATIVE STUDIES | 173 | ||
| RESEARCH DIFFICULTIES | 173 | ||
| CONCLUSIONS | 173 | ||
| REFERENCES | 174 | ||
| SUGGESTED READING | 174 | ||
| CHAPTER 33: Qualitative Methodology | 175 | ||
| DEVELOPMENTS IN QUALITATIVE RESEARCH METHODOLOGY | 176 | ||
| DATA CAPTURE AND TRANSFORMATION | 178 | ||
| DATA ANALYSIS | 178 | ||
| ASSESSING THE QUALITY OF QUALITATIVE RESEARCH | 180 | ||
| CONCLUSIONS | 180 | ||
| REFERENCES | 180 | ||
| SUGGESTED READING | 181 | ||
| CHAPTER 34: Priorities for the Future: The Research Agenda | 181 | ||
| THE EVIDENCE BASE | 181 | ||
| TOPICAL RESEARCH AGENDAS | 183 | ||
| PATIENT, FAMILY, AND CONSUMER RESEARCH AGENDAS | 186 | ||
| FUTURE DIRECTIONS | 186 | ||
| CONCLUSIONS AND CONTROVERSIES | 187 | ||
| REFERENCES | 187 | ||
| SUGGESTED READING | 188 | ||
| SECTION F: Administration | 189 | ||
| CHAPTER 35: Program Development: An International Perspective | 189 | ||
| INSTITUTIONALIZATION OF PALLIATIVE CARE | 189 | ||
| CONCLUSIONS | 191 | ||
| REFERENCES | 192 | ||
| SUGGESTED READING | 192 | ||
| CHAPTER 36: Program Development: National Planning | 192 | ||
| PALLIATIVE MEDICINE AS A SPECIALTY | 193 | ||
| COUNCIL OF EUROPE REPORT | 193 | ||
| NATIONAL STRATEGY FOR PALLIATIVE CARE | 194 | ||
| REFERENCES | 197 | ||
| SUGGESTED READING | 197 | ||
| CHAPTER 37: Program Development: Palliative Medicine and Public Health Services | 198 | ||
| PRINCIPLES AND AIMS OF A PUBLIC HEALTH APPROACH | 198 | ||
| COMBINED METHODS FOR IMPLEMENTING PROGRAMS | 199 | ||
| ELEMENTS OF RATIONAL PLANNING | 199 | ||
| SUCCESSFUL PALLIATIVE CARE EXPERIENCES | 202 | ||
| DILEMMAS AND CONTROVERSIES | 202 | ||
| FUTURE TRENDS | 202 | ||
| REFERENCES | 202 | ||
| SUGGESTED READING | 203 | ||
| CHAPTER 38: Consultation Services | 203 | ||
| HISTORY | 203 | ||
| STRUCTURE | 204 | ||
| PROCESS AND FUNCTIONS | 204 | ||
| OUTCOMES | 205 | ||
| DEVELOPMENTS IN THE USE OF HOSPITAL PALLIATIVE CARE TEAMS | 206 | ||
| RESEARCH CHALLENGES | 207 | ||
| REFERENES | 208 | ||
| SUGGESTED READING | 208 | ||
| CHAPTER 39: Acute Palliative Medicine Units | 208 | ||
| DEFINITION AND CHARACTERISTICS | 209 | ||
| RATIONALE | 209 | ||
| ISSUES BEYOND THE SCOPE OF ACUTE PALLIATIVE MEDICINE UNITS | 210 | ||
| CONCLUSIONS | 211 | ||
| REFERENCES | 212 | ||
| SUGGESTED READING | 212 | ||
| CHAPTER 40: Inpatient Hospice and Palliative Care Units | 212 | ||
| STARTING A SPECIALIZED UNIT | 212 | ||
| ADMINISTRATIVE CONSIDERATIONS | 213 | ||
| CLINICAL CONSIDERATIONS | 215 | ||
| ENVIRONMENTAL CONSIDERATIONS | 215 | ||
| SUGGESTED READING | 216 | ||
| CHAPTER 41: Palliative Medicine in Institutions | 216 | ||
| PALLIATIVE CARE IN NURSING FACILITIES | 216 | ||
| PALLIATIVE MEDICINE CONSULTATION AND OUTPATIENT CLINIC SERVICE | 217 | ||
| RESIDENTIAL CARE | 217 | ||
| PROGRAMS FOR ALL-INCLUSIVE CARE OF THE ELDERLY | 218 | ||
| OTHER SETTINGS FOR PALLIATIVE CARE | 218 | ||
| STATUS OF PALLIATIVE CARE AND RESEARCH OPPORTUNITIES | 218 | ||
| REFERENCES | 219 | ||
| SUGGESTED READING | 219 | ||
| CHAPTER 42: Home Care and Hospice Home Care | 219 | ||
| IMPORTANCE OF GOOD HOME CARE | 219 | ||
| CONSEQUENCES OF INADEQUATE HOME CARE | 220 | ||
| GOOD END-OF-LIFE CARE FOR ALL | 220 | ||
| MEETING THE CHALLENGE: KEY SOLUTIONS TO ENABLE GOOD HOME CARE | 221 | ||
| DEVELOPMENTS IN END-OF-LIFE CARE | 223 | ||
| CONCLUSIONS | 224 | ||
| REFERENCES | 224 | ||
| SUGGESTED READING | 224 | ||
| CHAPTER 43: The Business of Palliative Medicine: Quality Care in a Challenging Environment | 225 | ||
| THE BUSINESS PLAN | 225 | ||
| PROGRAM DEVELOPMENT | 225 | ||
| DELIVERY OF CARE | 227 | ||
| FINANCIAL FEASIBILITY | 228 | ||
| CONCLUSIONS | 228 | ||
| REFERENCES | 229 | ||
| SECTION G: Quality | 230 | ||
| CHAPTER 44: Development of National and International Standards | 230 | ||
| STANDARDS AND QUALITY IN PALLIATIVE CARE | 230 | ||
| CLASSIFICATION AND TYPES OF STANDARDS | 230 | ||
| NATIONAL STANDARDS | 231 | ||
| INTERNATIONAL STANDARDS | 237 | ||
| RESEARCH OPPORTUNITIES IN PALLIATIVE CARE | 239 | ||
| CONCLUSIONS | 239 | ||
| REFERENCES | 239 | ||
| SUGGESTED READING | 239 | ||
| CHAPTER 45: Clinical Practice Guidelines | 239 | ||
| GUIDELINE DEVELOPMENT | 240 | ||
| DISSEMINATION AND IMPLEMENTATION | 243 | ||
| QUALITY OF CLINICAL PRACTICE GUIDELINES | 243 | ||
| RISKS AND BENEFITS | 243 | ||
| PRACTICE GUIDELINES AND PALLIATIVE CARE | 243 | ||
| PROGRESS IN GUIDELINE DEVELOPMENT AND RESEARCH OPPORTUNITIES | 244 | ||
| CONCLUSIONS | 244 | ||
| REFERENCES | 244 | ||
| SUGGESTED READING | 245 | ||
| CHAPTER 46: Evidence-Based Economic Evaluation | 245 | ||
| ECONOMIC EVALUATION | 246 | ||
| GUIDANCE FOR CONDUCTING AN ECONOMIC EVALUATION | 248 | ||
| DEVELOPMENTS AND OPPORTUNITIES | 250 | ||
| REFERENCES | 251 | ||
| SECTION H: Health Professions, Family, and Volunteers | 253 | ||
| CHAPTER 47: The Interdisciplinary Team | 253 | ||
| DISCIPLINE AND PROFESSION | 253 | ||
| TEAMS AND TEAMWORK | 254 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 257 | ||
| CONCLUSIONS | 258 | ||
| REFERENCES | 259 | ||
| SUGGESTED READING | 259 | ||
| CHAPTER 48: The Physician | 259 | ||
| SUSTAINING CONCEPTS OF MEDICAL PRACTICE | 261 | ||
| CONCLUSIONS | 264 | ||
| REFERENCES | 264 | ||
| CHAPTER 49: Nurses and Nurse Practitioners | 265 | ||
| PALLIATIVE NURSING | 265 | ||
| KEY CONSTRUCTS WITHIN PALLIATIVE NURSING | 266 | ||
| DEVELOPMENTS AND OPPORTUNITIES IN PALLIATIVE NURSING | 266 | ||
| CONTROVERSIES AND RESEARCH OPPORTUNITIES | 267 | ||
| CONCLUSIONS | 268 | ||
| REFERENCES | 269 | ||
| SUGGESTED READING | 269 | ||
| CHAPTER 50: The Social Worker | 269 | ||
| FUNCTION OF SOCIAL WORK | 269 | ||
| ROLES OF SOCIAL WORKERS | 271 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 272 | ||
| REFERENCES | 273 | ||
| SUGGESTED READING | 273 | ||
| CHAPTER 51: The Nutrition Support Team | 273 | ||
| SPECIALIZED NUTRITIONAL SUPPORT DURING ADVANCED DISEASE | 274 | ||
| RATIONALE FOR THE TEAM APPROACH TO SPECIALIZED NUTRITIONAL SUPPORT | 274 | ||
| NUTRITIONAL SUPPORT TEAMS: ESTABLISHMENT, ORGANIZATION, AND FUTURE CONSIDERATIONS | 275 | ||
| CONCLUSIONS | 275 | ||
| REFERENCES | 276 | ||
| CHAPTER 52: Occupational and Physical Therapy | 277 | ||
| OCCUPATIONAL AND PHYSICAL THERAPY DEFINED | 277 | ||
| GOALS OF OCCUPATIONAL THERAPY AND PHYSICAL THERAPY IN PALLIATIVE MEDICINE | 277 | ||
| MODELS OF OCCUPATIONAL THERAPY AND PHYSICAL THERAPY SERVICE DELIVERY IN PALLIATIVE MEDICINE | 277 | ||
| REIMBURSEMENT FOR OCCUPATIONAL THERAPY AND PHYSICAL THERAPY SERVICES IN PALLIATIVE MEDICINE | 278 | ||
| EVIDENCE-BASED PRACTICE | 278 | ||
| CONCLUSIONS | 278 | ||
| REFERENCES | 278 | ||
| SUGGESTED READING | 278 | ||
| CHAPTER 53: The Speech-Language Pathologist | 279 | ||
| DISORDERS OF LANGUAGE | 279 | ||
| DISORDERS OF COGNITIVE-LINGUISTIC SKILLS | 280 | ||
| DISORDERS OF SPEECH PRODUCTION AND VOICE | 280 | ||
| SWALLOWING DISORDERS | 281 | ||
| DEVELOPMENTS AND OPPORTUNITIES IN RESEARCH | 281 | ||
| CONCLUSIONS | 281 | ||
| REFERENCES | 282 | ||
| SUGGESTED READING | 282 | ||
| CHAPTER 54: Psychiatrists and Clinical Psychologists | 282 | ||
| PSYCHOLOGICAL DISTRESS IN PALLIATIVE CARE | 283 | ||
| PROVISION OF PSYCHOLOGICAL AND PSYCHIATRIC CARE | 285 | ||
| CONCLUSIONS AND FUTURE DIRECTIONS | 288 | ||
| REFERENCES | 288 | ||
| SUGGESTED READING | 288 | ||
| CHAPTER 55: Spiritual Care | 289 | ||
| HOLISTIC MODELS OF CARE | 289 | ||
| PRACTICAL TOOLS FOR HEALTH CARE PROFESSIONALS | 290 | ||
| THE SPIRITUAL HISTORY | 291 | ||
| CONCLUSIONS | 292 | ||
| REFERENCES | 293 | ||
| CHAPTER 56: The Role of the Clinical Pharmacist | 293 | ||
| PHARMACOTHERAPEUTIC ADVICE | 293 | ||
| PRACTICES OF PHARMACISTS | 295 | ||
| REFERENCES | 296 | ||
| SUGGESTED READING | 296 | ||
| CHAPTER 57: Palliative Medicine and the Ethics Consultant | 297 | ||
| HISTORICAL BACKGROUND | 297 | ||
| ROLE AND MODELS OF ETHICS CONSULTATION | 297 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 298 | ||
| CONCLUSIONS | 299 | ||
| REFERENCES | 299 | ||
| SUGGESTED READING | 299 | ||
| CHAPTER 58: Music and Art Therapists | 299 | ||
| HISTORICAL BACKGROUND | 299 | ||
| DEFINITION AND QUALIFICATIONS | 300 | ||
| MUSIC AND ART THERAPY | 300 | ||
| DEVELOPMENTS AND DEBATES IN PALLIATIVE CARE | 301 | ||
| CONCLUSIONS | 302 | ||
| REFERENCES | 302 | ||
| SUGGESTED READING | 302 | ||
| CHAPTER 59: Wound and Stoma Therapists | 303 | ||
| WOUND AND STOMA THERAPY | 303 | ||
| STAFF EDUCATION | 303 | ||
| ADVANCED WOUND CARE | 303 | ||
| CONCLUSIONS | 304 | ||
| REFERENCES | 305 | ||
| SUGGESTED READING | 305 | ||
| CHAPTER 60: The Volunteer | 305 | ||
| CONTRIBUTIONS OF VOLUNTEERS | 305 | ||
| CHARACTERISTICS, ROLES, AND DUTIES OF VOLUNTARY WORKERS | 306 | ||
| INTEGRATION | 308 | ||
| REFERENCES | 308 | ||
| CHAPTER 61: History and Physical Examination | 308 | ||
| GOALS OF THE HISTORY AND EXAMINATION | 308 | ||
| CLINICAL HISTORY | 309 | ||
| CARE PLANNING | 311 | ||
| EXAMINATION | 311 | ||
| NUTRITIONAL ASSESSMENT | 314 | ||
| CONCLUSIONS | 315 | ||
| REFERENCES | 316 | ||
| SUGGESTED READING | 316 | ||
| PART II: The Patient | 319 | ||
| SECTION A: Patient Evaluation | 320 | ||
| CHAPTER 62: Assessing the Family and Caregivers | 320 | ||
| DEFINITIONS | 320 | ||
| FACTORS INFLUENCING CAREGIVERS | 321 | ||
| CIRCUMSTANCES OF CARE | 322 | ||
| ASSESSING THE FAMILY CAREGIVER EXPERIENCE | 323 | ||
| REFERENCES | 325 | ||
| SUGGESTED READING | 325 | ||
| CHAPTER 63: Clinical Symptom Assessment | 325 | ||
| SYMPTOMS THAT SHOULD BE ASSESSED | 326 | ||
| CLINICAL SYMPTOM ASSESSMENT | 326 | ||
| SYMPTOM ASSESSMENT INSTRUMENTS | 327 | ||
| PAIN | 328 | ||
| FATIGUE | 330 | ||
| SPECIAL POPULATIONS | 331 | ||
| CONCLUSIONS AND RESEARCH CHALLENGES | 331 | ||
| REFERENCES | 332 | ||
| SUGGESTED READING | 332 | ||
| CHAPTER 64: Qualitative and Quantitative Symptom Assessment | 333 | ||
| PRINCIPLES OF ASSESSMENT AND MEASUREMENT | 333 | ||
| CLINICAL EVALUATION AND DIAGNOSIS | 335 | ||
| DEVELOPMENTS AND CONTROVERSIES IN ASSESSMENT | 336 | ||
| REFERENCES | 340 | ||
| SUGGESTED READING | 341 | ||
| CHAPTER 65: Measuring Quality of Life | 341 | ||
| QUALITY OF LIFE: DEFINITION AND STRUCTURE | 341 | ||
| PRINCIPLES OF ASSESSMENT AND MEASUREMENT | 343 | ||
| INSTRUMENTS | 344 | ||
| CLINICAL EVALUATION: STRUCTURE OF ASSESSMENT | 348 | ||
| DEVELOPMENTS, DEBATES, AND RESEARCH | 349 | ||
| CONCLUSIONS | 350 | ||
| REFERENCES | 351 | ||
| SUGGESTED READING | 352 | ||
| CHAPTER 66: The Neuropsychological Examination | 352 | ||
| CLINICAL EVALUATION | 352 | ||
| COMPONENTS OF THE NEUROPSYCHOLOGICAL ASSESSMENT | 353 | ||
| ASSESSMENT TOOLS | 353 | ||
| REFERENCES | 355 | ||
| SUGGESTED READING | 355 | ||
| CHAPTER 67: Sexuality and Intimacy in the Critically Ill | 355 | ||
| DEFINITIONS OF SEXUALITY | 355 | ||
| SEXUALITY AND SOCIETY | 356 | ||
| SEXUALITY AND SEXUAL NEEDS OF THE CRITICALLY ILL | 356 | ||
| THE MEANING OF SEXUALITY FOR CAREGIVERS | 356 | ||
| COMMUNICATION PROBLEMS | 357 | ||
| INTERVENTIONS | 357 | ||
| SEXUAL COUNSELING | 359 | ||
| REFERENCES | 359 | ||
| SUGGESTED READING | 359 | ||
| CHAPTER 68: Assessment of Mobility | 359 | ||
| PRINCIPLES OF ASSESSMENT | 359 | ||
| ASSESSMENT TOOLS | 359 | ||
| CONCLUSIONS AND RESEARCH OPPORTUNITIES | 363 | ||
| REFERENCES | 363 | ||
| SECTION B: Investigations | 364 | ||
| CHAPTER 69: Nuclear Medicine | 364 | ||
| BONE SCINTIGRAPHY | 364 | ||
| POSITRON EMISSION TOMOGRAPHY | 365 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 366 | ||
| SUGGESTED READING | 366 | ||
| CHAPTER 70: Computed Tomography Scanning and Magnetic Resonance Imaging in Palliative Care | 367 | ||
| COMPUTED TOMOGRAPHY | 367 | ||
| MAGNETIC RESONANCE IMAGING | 369 | ||
| SUGGESTED READING | 370 | ||
| CHAPTER 71: Positron Emission Tomography | 371 | ||
| TECHNIQUE | 372 | ||
| INDICATIONS AND CONTRAINDICATIONS | 374 | ||
| COMPLICATIONS | 376 | ||
| FUTURE CONSIDERATIONS | 376 | ||
| REFERENCES | 378 | ||
| CHAPTER 72: Cardiac Function Testing | 378 | ||
| THE TESTS | 379 | ||
| FUTURE CONSIDERATIONS | 384 | ||
| REFERENCES | 384 | ||
| SUGGESTED READING | 385 | ||
| CHAPTER 73: Pulmonary Function | 385 | ||
| SPIROMETRY | 385 | ||
| FLOW-VOLUME LOOPS | 386 | ||
| PEAK FLOW READINGS | 386 | ||
| LUNG VOLUMES | 388 | ||
| DIFFUSION CAPACITY | 388 | ||
| CHALLENGE TESTS | 389 | ||
| ARTERIAL BLOOD GAS DETERMINATIONS | 389 | ||
| TESTS OF RESPIRATORY MUSCLE STRENGTH | 389 | ||
| CONCLUSIONS | 390 | ||
| REFERENCES | 390 | ||
| SUGGESTED READING | 390 | ||
| CHAPTER 74: Laboratory Hematology | 390 | ||
| INDICATIONS AND CONTRAINDICATIONS | 391 | ||
| TECHNIQUES | 393 | ||
| INTERPRETATION OF RESULTS | 394 | ||
| REFERENCES | 403 | ||
| SUGGESTED READING | 404 | ||
| CHAPTER 75: The Role of Pathology | 404 | ||
| AUTOPSY | 404 | ||
| BIOPSIES | 405 | ||
| FROZEN SECTION | 407 | ||
| CYTOLOGY | 407 | ||
| REFERENCES | 408 | ||
| SUGGESTED READING | 408 | ||
| SECTION C: Co-morbidities | 409 | ||
| CHAPTER 76: Common Medical and Surgical Disorders | 409 | ||
| PEPTIC ULCER DISEASE | 409 | ||
| GASTROESOPHAGEAL REFLUX DISEASE | 409 | ||
| CELLULITIS | 410 | ||
| ROTATOR CUFF INJURY | 411 | ||
| PREVENTIVE MEDICINE | 411 | ||
| ECZEMA | 412 | ||
| REFERENCES | 412 | ||
| SUGGESTED READING | 413 | ||
| CHAPTER 77: Common Musculoskeletal Co-morbidities | 413 | ||
| MUSCULOSKELETAL CHRONIC PAIN DISORDERS WITHOUT PHYSICAL PATHOLOGY | 413 | ||
| DEGENERATIVE JOINT, TENDON, AND BONE DISEASES | 413 | ||
| OSTEOPOROSIS | 414 | ||
| CRYSTAL-INDUCED ARTHRITIS | 414 | ||
| RHEUMATOID ARTHRITIS | 415 | ||
| SPONDYLOARTHROPATHIES | 415 | ||
| CONNECTIVE TISSUE DISEASES | 416 | ||
| INFECTION AND THE MUSCULOSKELETAL SYSTEM | 416 | ||
| MALIGNANCY-ASSOCIATED MUSCULOSKELETAL DISORDERS | 416 | ||
| SUGGESTED READING | 417 | ||
| CHAPTER 78: Diabetes Mellitus | 417 | ||
| EPIDEMIOLOGY AND PREVALENCE | 417 | ||
| BASIC SCIENCE | 418 | ||
| PATHOPHYSIOLOGY | 418 | ||
| CLINICAL MANIFESTATIONS | 418 | ||
| DIFFERENTIAL DIAGNOSIS | 419 | ||
| TREATMENT | 419 | ||
| DRUGS OF CHOICE AND SUPPORTIVE CARE | 422 | ||
| REFERENCES | 425 | ||
| SUGGESTED READING | 425 | ||
| CHAPTER 79: Heart Failure | 426 | ||
| EPIDEMIOLOGY | 426 | ||
| PATHOPHYSIOLOGY | 426 | ||
| DIAGNOSIS AND MANAGEMENT | 426 | ||
| TREATMENT | 426 | ||
| CLINICAL MANIFESTATIONS | 427 | ||
| MANAGEMENT | 427 | ||
| REFERENCES | 431 | ||
| SUGGESTED READING | 431 | ||
| CHAPTER 80: Arrhythmias | 431 | ||
| EPIDEMIOLOGY AND PREVALENCE | 432 | ||
| PATHOPHYSIOLOGY | 432 | ||
| CLINICAL MANIFESTATIONS | 432 | ||
| WITHDRAWAL OF IMPLANTABLE CARDIOVERTER DEFIBRILLATOR AND PACEMAKER THERAPY | 434 | ||
| CONCLUSIONS | 434 | ||
| REFERENCES | 434 | ||
| CHAPTER 81: Hypertension | 435 | ||
| PATHOPHYSIOLOGY | 435 | ||
| EVALUATION OF HYPERTENSION | 437 | ||
| TREATMENT | 438 | ||
| EFFECTIVENESS | 442 | ||
| SUPPORTIVE CARE | 442 | ||
| REFERENCES | 442 | ||
| CHAPTER 82: Kidney Failure | 443 | ||
| EPIDEMIOLOGY AND PREVALENCE | 443 | ||
| PATHOPHYSIOLOGY | 444 | ||
| CLINICAL MANIFESTATIONS | 445 | ||
| DIAGNOSIS | 445 | ||
| TREATMENT | 447 | ||
| DRUGS OF CHOICE | 449 | ||
| SUPPORTIVE CARE | 449 | ||
| REFERENCES | 451 | ||
| CHAPTER 83: Alcohol and Drug Abuse | 451 | ||
| EPIDEMIOLOGY AND PREVALENCE | 452 | ||
| BASIC SCIENCE | 452 | ||
| PATHOPHYSIOLOGY | 453 | ||
| CLINICAL MANIFESTATIONS | 453 | ||
| MANAGEMENT | 454 | ||
| REFERENCES | 457 | ||
| SUGGESTED READING | 458 | ||
| SECTION D: Complications of Advanced Disease | 459 | ||
| CHAPTER 84: Liver Failure | 459 | ||
| CHRONIC LIVER FAILURE | 459 | ||
| CHRONIC CHOLESTASIS | 459 | ||
| CLINICAL COMPLICATIONS OF PORTAL HYPERTENSION | 460 | ||
| HEPATIC ENCEPHALOPATHY | 460 | ||
| ACUTE-ON-CHRONIC LIVER FAILURE | 462 | ||
| RESEARCH ADVANCES | 463 | ||
| REFERENCES | 464 | ||
| SUGGESTED READING | 465 | ||
| CHAPTER 85: Deep Vein Thrombosis | 465 | ||
| CLINICAL EVALUATION AND DIAGNOSIS | 465 | ||
| DIFFICULTIES IN THE MANAGEMENT OF VENOUS THROMBOEMBOLISM | 465 | ||
| PRESENTATION AND DIAGNOSIS OF DEEP VEIN THROMBOSIS | 466 | ||
| PRESENTATION AND DIAGNOSIS OF PULMONARY EMBOLUS | 467 | ||
| ACUTE MANAGEMENT | 468 | ||
| COMMON ERRORS | 469 | ||
| RESEARCH CHALLENGES | 469 | ||
| REFERENCES | 469 | ||
| SUGGESTED READING | 470 | ||
| CHAPTER 86: Persistent or Repeated Hemorrhage | 470 | ||
| BASIC SCIENCE | 470 | ||
| EPIDEMIOLOGY AND PREVALENCE | 470 | ||
| PATHOPHYSIOLOGY | 470 | ||
| CLINICAL MANIFESTATIONS | 471 | ||
| DIFFERENTIAL DIAGNOSIS | 471 | ||
| TREATMENT | 472 | ||
| DRUGS OF CHOICE | 473 | ||
| SUPPORTIVE CARE | 473 | ||
| REFERENCES | 474 | ||
| SUGGESTED READING | 474 | ||
| CHAPTER 87: Lymphedema | 474 | ||
| EPIDEMIOLOGY AND PREVALENCE | 475 | ||
| PATHOPHYSIOLOGY | 475 | ||
| CLINICAL MANIFESTATIONS | 475 | ||
| DIFFERENTIAL DIAGNOSIS | 475 | ||
| TREATMENT | 476 | ||
| EVIDENCE-BASED MEDICINE | 478 | ||
| REFERENCES | 478 | ||
| SUGGESTED READING | 478 | ||
| CHAPTER 88: Pressure Ulcers and Wound Care | 478 | ||
| BASIC SCIENCE | 478 | ||
| EPIDEMIOLOGY AND PREVALENCE | 479 | ||
| PATHOPHYSIOLOGY | 479 | ||
| CLINICAL MANIFESTATIONS | 479 | ||
| DIFFERENTIAL DIAGNOSIS | 479 | ||
| TREATMENT | 480 | ||
| FUTURE CONSIDERATIONS | 480 | ||
| REFERENCES | 484 | ||
| SUGGESTED READING | 484 | ||
| CHAPTER 89: Stomas and Fistulas | 484 | ||
| STOMAS | 484 | ||
| ROUTINE CARE | 485 | ||
| TREATMENT | 486 | ||
| FISTULAS | 488 | ||
| PATHOPHYSIOLOGY | 489 | ||
| TREATMENT | 489 | ||
| CONCLUSIONS | 491 | ||
| REFERENCES | 491 | ||
| SUGGESTED READING | 491 | ||
| CHAPTER 90: Emergencies in Palliative Medicine | 492 | ||
| ACUTE PULMONARY EMBOLUS | 492 | ||
| ACUTE PNEUMONIA | 495 | ||
| HYPOPROTEINEMIC EDEMA | 497 | ||
| SEIZURES AND STATUS EPILEPTICUS | 498 | ||
| ACUTE MYOCARDIAL INFARCTION | 500 | ||
| SEPSIS | 501 | ||
| FAMILY CRISIS | 503 | ||
| SUGGESTED READING | 504 | ||
| SECTION E: Infections | 505 | ||
| CHAPTER 91: Infections In Palliative Medicine | 505 | ||
| INCIDENCE | 505 | ||
| CONTRIBUTING FACTORS | 505 | ||
| SIGNS AND SYMPTOMS OF INFECTION | 506 | ||
| DIAGNOSTIC TESTS | 506 | ||
| COMMON INFECTIONS IN ADVANCED ILLNESS | 507 | ||
| TREATMENT OF INFECTIONS IN ADVANCED ILLNESS | 507 | ||
| CONTROVERSIES | 507 | ||
| CONCLUSIONS | 508 | ||
| REFERENCES | 508 | ||
| CHAPTER 92: Prevention and Control of Infections | 509 | ||
| BASIC PRINCIPLES OF INFECTION CONTROL | 509 | ||
| HAND HYGIENE | 510 | ||
| PERSONAL PROTECTIVE EQUIPMENT | 510 | ||
| ISOLATION PRECAUTIONS | 511 | ||
| HANDLING AND DISPOSAL OF SHARPS | 511 | ||
| WASTE HANDLING AND DISPOSAL | 512 | ||
| CLEANING AND DECONTAMINATION | 512 | ||
| IMMUNIZATION OF PATIENTS | 512 | ||
| PREVENTION OF DEVICE-RELATED INFECTION | 512 | ||
| WOUND MANAGEMENT | 513 | ||
| MULTIDRUG-RESISTANT ORGANISMS | 513 | ||
| TUBERCULOSIS | 514 | ||
| VARICELLA ZOSTER VIRUS | 514 | ||
| PROTECTION OF THE HEALTH CARE WORKER | 514 | ||
| BLOODBORNE VIRUSES | 515 | ||
| SURVEILLANCE | 515 | ||
| HOME CARE | 515 | ||
| REFERENCES | 515 | ||
| SUGGESTED READING | 516 | ||
| CHAPTER 93: Urinary Tract Infections | 516 | ||
| BASIC SCIENCE | 516 | ||
| EPIDEMIOLOGY AND PREVALENCE | 517 | ||
| PATHOPHYSIOLOGY | 517 | ||
| CLINICAL MANIFESTATIONS | 517 | ||
| DIAGNOSIS | 517 | ||
| TREATMENT | 518 | ||
| PREVENTION | 518 | ||
| REFERENCES | 518 | ||
| CHAPTER 94: Health Care–Acquired Infections | 519 | ||
| NOSOCOMIAL PNEUMONIA | 519 | ||
| URINARY TRACT INFECTIONS | 522 | ||
| INFECTIONS RELATED TO THE PRESENCE OF PERCUTANEOUS DEVICES | 523 | ||
| NOSOCOMIAL DIARRHEA | 524 | ||
| WOUND INFECTIONS | 526 | ||
| REFERENCES | 526 | ||
| CHAPTER 95: Fatal and Fulminant Infections | 527 | ||
| BASIC SCIENCE AND EPIDEMIOLOGY | 527 | ||
| DISCUSSION | 529 | ||
| REFERENCES | 531 | ||
| CHAPTER 96: Antimicrobial Use in the Dying | 532 | ||
| PATIENT FACTORS | 532 | ||
| TREATMENT GOALS | 532 | ||
| INFECTION-SPECIFIC FACTORS | 532 | ||
| ANTIBIOTIC SELECTION | 533 | ||
| ETHICAL CONSIDERATIONS | 534 | ||
| REFERENCES | 534 | ||
| SUGGESTED READING | 534 | ||
| SECTION F: Procedures and Devices | 535 | ||
| CHAPTER 97: Palliative Surgery | 535 | ||
| PRINCIPLES OF SURGICAL PALLIATIVE CARE AND PALLIATIVE SURGERY | 535 | ||
| GENERAL CONSIDERATIONS | 535 | ||
| PREOPERATIVE EVALUATION | 536 | ||
| PALLIATIVE PROCEDURES | 536 | ||
| SUGGESTED READING | 541 | ||
| REFERENCES | 541 | ||
| CHAPTER 98: Gastrointestinal Endoscopy | 541 | ||
| PATIENT SELECTION | 541 | ||
| SEDATION AND ANALGESIA | 542 | ||
| COMPLICATIONS | 542 | ||
| GASTROINTESTINAL ENDOSCOPIC PROCEDURES | 542 | ||
| FUTURE DEVELOPMENTS | 544 | ||
| SUMMARY | 544 | ||
| REFERENCES | 544 | ||
| CHAPTER 99: Palliative Management of Airway Obstruction: Tracheostomy and Airway Stents | 544 | ||
| INDICATIONS | 544 | ||
| CLINICAL PRESENTATION AND EVALUATION | 545 | ||
| EQUIPMENT | 545 | ||
| DESCRIPTION OF TECHNIQUES | 545 | ||
| EVIDENCE-BASED MEDICINE | 547 | ||
| CURRENT CONTROVERSIES AND FUTURE CONSIDERATIONS | 548 | ||
| REFERENCES | 549 | ||
| SUGGESTED READING | 549 | ||
| CHAPTER 100: Pleural and Peritoneal Catheters | 550 | ||
| PLEURAL CATHETERS | 550 | ||
| PERITONEAL CATHETERS | 552 | ||
| REFERENCES | 555 | ||
| SUGGESTED READING | 555 | ||
| CHAPTER 101: Interventional Radiology | 555 | ||
| CENTRAL VENOUS ACCESS | 555 | ||
| VENA CAVA FILTERS | 558 | ||
| EMBOLOTHERAPY | 561 | ||
| TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT PLACEMENT | 563 | ||
| REFERENCES | 565 | ||
| CHAPTER 102: Durable Medical Equipment | 565 | ||
| CLINICAL PRESENTATION AND EVALUATION | 566 | ||
| EQUIPMENT AND DEVICES TO ASSIST SELF-CARE | 566 | ||
| BATH AND TOILET AIDS | 568 | ||
| BED MOBILITY AND POSITIONING | 568 | ||
| PRESSURE-RELIEVING BEDS AND MATTRESSES | 568 | ||
| TRANSFER AIDS | 569 | ||
| AMBULATION AIDS | 569 | ||
| LOWER EXTREMITY ORTHOSES | 571 | ||
| WHEELCHAIR MOBILITY | 571 | ||
| POWER WHEELCHAIRS | 572 | ||
| CURRENT CONTROVERSIES AND RESEARCH OPPORTUNITIES | 573 | ||
| CONCLUSION | 573 | ||
| REFERENCES | 573 | ||
| CHAPTER 103: Communication Devices | 573 | ||
| INDICATIONS AND CONTRAINDICATIONS | 573 | ||
| CLINICAL PRESENTATION AND EVALUATION | 573 | ||
| EQUIPMENT | 574 | ||
| DESCRIPTION OF TECHNIQUES AND TRAINING | 575 | ||
| COMPLICATIONS | 575 | ||
| EVIDENCE-BASED MEDICINE | 576 | ||
| REFERENCES | 576 | ||
| SUGGESTED READING | 576 | ||
| SECTION G: Nutrition | 577 | ||
| CHAPTER 104: Physiology of Nutrition and Aging | 577 | ||
| BASIC SCIENCE | 577 | ||
| ESSENTIAL MACRONUTRIENTS: ENERGETICS, METABOLISM, AND STARVATION | 579 | ||
| CONCLUSIONS | 581 | ||
| REFERENCES | 581 | ||
| SUGGESTED READING | 581 | ||
| CHAPTER 105: Determination of Nutrition and Hydration | 582 | ||
| BASIC SCIENCE | 582 | ||
| EPIDEMIOLOGY AND PREVALENCE | 584 | ||
| PATHOPHYSIOLOGY | 584 | ||
| CLINICAL MANIFESTATIONS | 584 | ||
| TREATMENT | 586 | ||
| REFERENCES | 586 | ||
| CHAPTER 106: The Anorexia-Cachexia Syndrome | 587 | ||
| EPIDEMIOLOGY AND PREVALENCE | 587 | ||
| PATHOPHYSIOLOGY | 588 | ||
| CLINICAL MANIFESTATIONS | 590 | ||
| DIFFERENTIAL DIAGNOSIS | 591 | ||
| TREATMENT | 591 | ||
| SUPPORTIVE CARE | 594 | ||
| REFERENCES | 595 | ||
| SUGGESTED READING | 595 | ||
| CHAPTER 107: Clinical Nutrition | 595 | ||
| EPIDEMIOLOGY AND PREVALENCE | 595 | ||
| ASSESSMENT OF NUTRITIONAL STATUS | 596 | ||
| PATHOPHYSIOLOGY AND CLINICAL MANIFESTATIONS | 599 | ||
| TREATMENT | 599 | ||
| EVIDENCE FOR NUTRITION INTERVENTION | 600 | ||
| REFERENCES | 602 | ||
| CHAPTER 108: Principles and Management of Nutritional Support in Cancer | 602 | ||
| BASIC SCIENCE | 603 | ||
| EPIDEMIOLOGY AND PREVALENCE | 603 | ||
| PATHOPHYSIOLOGY | 603 | ||
| IMPROVED SURVIVAL AND QUALITY OF LIFE | 604 | ||
| TREATMENT | 604 | ||
| OUTCOME OF ARTIFICIAL NUTRITION | 605 | ||
| ORAL SUPPLEMENTATION WITH EICOSAPENTAENOIC ACID | 606 | ||
| CONTROVERSIES | 606 | ||
| PERSPECTIVES | 606 | ||
| REFERENCES | 607 | ||
| SUGGESTED READING | 607 | ||
| CHAPTER 109: Nutrition in Palliative Medicine | 607 | ||
| NUTRITION AND CANCER | 607 | ||
| NUTRITIONAL ASSESSMENT | 608 | ||
| NUTRITIONAL THERAPY | 608 | ||
| NUTRITIONAL SUPPORT FOR THE TERMINALLY ILL | 608 | ||
| DEHYDRATION IN TERMINAL ILLNESS | 609 | ||
| DECISION MAKING | 610 | ||
| CONCLUSIONS | 611 | ||
| REFERENCES | 611 | ||
| SUGGESTED READING | 611 | ||
| SECTION H: Communication | 613 | ||
| CHAPTER 110: Good Communication: Patients, Families, and Professionals | 613 | ||
| EVIDENCE-BASED MEDICINE | 613 | ||
| RECENT DEVELOPMENTS | 614 | ||
| EFFECTIVE COMMUNICATION STRATEGIES | 615 | ||
| COMMON ERRORS | 618 | ||
| CONTROVERSIES | 619 | ||
| CONCLUSIONS | 619 | ||
| REFERENCES | 619 | ||
| CHAPTER 111: Telling the Truth: Bad News | 620 | ||
| TELLING THE TRUTH ABOUT A TERMINAL PROGNOSIS | 620 | ||
| DISCUSSING PROGNOSIS | 620 | ||
| TRANSITION FROM A CURATIVE TO A PALLIATIVE APPROACH | 622 | ||
| BALANCING HOPE AND TRUTH TELLING | 622 | ||
| EVIDENCE-BASED MEDICINE | 623 | ||
| CONCLUSIONS | 624 | ||
| REFERENCES | 624 | ||
| SUGGESTED READING | 625 | ||
| CHAPTER 112: Problems in Communication | 625 | ||
| COMPONENTS OF COMMUNICATION PROBLEMS | 625 | ||
| DIFFICULT CONVERSATIONS | 626 | ||
| AN APPROACH TO HANDLING EMOTIONS | 627 | ||
| CONCLUSIONS, CHALLENGES, AND OPPORTUNITIES | 628 | ||
| REFERENCES | 629 | ||
| SUGGESTED READING | 630 | ||
| CHAPTER 113: Counseling | 630 | ||
| TREATMENT INTERVENTIONS | 630 | ||
| EVIDENCE-BASED MEDICINE | 632 | ||
| CONTROVERSIES AND RESEARCH OPPORTUNITIES | 633 | ||
| CONCLUSIONS | 634 | ||
| REFERENCES | 634 | ||
| SUGGESTED READING | 634 | ||
| CHAPTER 114: Public Advocacy and Community Outreach | 634 | ||
| ADVOCACY AND COMMUNITY OUTREACH IN PALLIATIVE MEDICINE | 635 | ||
| THE ITALIAN EXPERIENCE: A SUCCESS STORY | 635 | ||
| RECENT DEVELOPMENTS | 636 | ||
| CONCLUSIONS | 636 | ||
| REFERENCES | 637 | ||
| SUGGESTED READING | 637 | ||
| CHAPTER 115: Telemedicine | 637 | ||
| DEFINITIONS | 638 | ||
| PROPOSED BENEFITS OF TELEMEDICINE AND E-HEALTH | 638 | ||
| TECHNOLOGICAL CONCEPTS UNDERLYING TELEMEDICINE AND E-HEALTH | 638 | ||
| RECENT DEVELOPMENTS | 638 | ||
| GENERAL APPLICATIONS OF TELEMEDICINE AND E-HEALTH | 639 | ||
| EVIDENCE-BASES | 639 | ||
| APPLICATIONS IN PALLIATIVE CARE | 640 | ||
| HEALTH INFORMATICS | 641 | ||
| CONCLUSIONS | 641 | ||
| REFERENCES | 642 | ||
| SUGGESTED READING | 642 | ||
| SECTION I: Decision Making | 643 | ||
| CHAPTER 116: Making Good Decisions | 643 | ||
| CONCEPTS IN GOOD DECISION MAKING | 643 | ||
| TO BE PRUDENT, NOT TO BE CERTAIN | 643 | ||
| RESPONSIBILITY AND PROFESSIONAL FREEDOM IN MAKING DECISIONS | 644 | ||
| RESPECTING AUTONOMY IN DECISION MAKING | 645 | ||
| THE WISE DECISION | 645 | ||
| THREE-STEP FRAMEWORK FOR APPROACHING MAKING GOOD DECISIONS | 646 | ||
| HIDDEN TRAPS OF DECISION MAKING | 646 | ||
| RECENT DEVELOPMENTS | 647 | ||
| CONCLUSIONS | 647 | ||
| REFERENCES | 647 | ||
| SUGGESTED READING | 647 | ||
| CHAPTER 117: Denial and Decision-Making Capacity | 647 | ||
| EFFECTS OF DENIAL BY THE PATIENT | 648 | ||
| DENIAL IN PATIENTS AND FAMILIES | 648 | ||
| DENIAL IN PROFESSIONALS | 648 | ||
| POSSIBLE DETERMINANTS OF DENIAL | 648 | ||
| INTERVENTIONS | 648 | ||
| RECENT DEVELOPMENTS | 649 | ||
| CONCLUSIONS | 650 | ||
| RESEARCH CHALLENGES | 650 | ||
| REFERENCES | 650 | ||
| SUGGESTED READING | 650 | ||
| CHAPTER 118: Evidence-Based Decision Making: Challenges and Opportunities | 651 | ||
| DEFINITIONS OF EVIDENCE-BASED MEDICINE | 651 | ||
| LACK OF EVIDENCE-BASED DECISION MAKING IN PALLIATIVE MEDICINE | 651 | ||
| BARRIERS TO EVIDENCE-BASED PRACTICE IN PALLIATIVE MEDICINE | 652 | ||
| BUILDING BLOCKS OF EVIDENCE-BASED DECISION MAKING | 652 | ||
| CORE SKILLS IN EVIDENCE-BASED MEDICINE | 654 | ||
| ACTION STEPS TO EVIDENCE-BASED DECISION MAKING IN PALLIATIVE MEDICINE | 655 | ||
| EVIDENCE-BASED PALLIATIVE MEDICINE | 655 | ||
| RECENT DEVELOPMENTS IN EVIDENCE-BASED DECISION MAKING | 656 | ||
| REFERENCES | 656 | ||
| SUGGESTED READING | 657 | ||
| CHAPTER 119: Determining Prognosis | 657 | ||
| SUBJECTIVE SURVIVAL PREDICTIONS | 657 | ||
| ACTUARIAL JUDGMENT | 658 | ||
| RECENT DEVELOPMENTS | 659 | ||
| EVIDENCE-BASED MEDICINE | 660 | ||
| CONCLUSIONS | 661 | ||
| RESEARCH CHALLENGES | 661 | ||
| REFERENCES | 662 | ||
| SUGGESTED READING | 662 | ||
| CHAPTER 120: The Plan of Care | 662 | ||
| CONTINUITY AND COORDINATION OF CARE | 663 | ||
| COMMUNICATION AND THE FAMILY CONFERENCE | 663 | ||
| HOLDING PARADOX: HOPE AND PREPARATION | 664 | ||
| CULTURE | 664 | ||
| ADVANCE DIRECTIVES | 664 | ||
| RECENT DEVELOPMENTS | 664 | ||
| EVIDENCE-BASED MEDICINE | 665 | ||
| CONCLUSIONS | 665 | ||
| RESEARCH CHALLENGES | 665 | ||
| REFERENCES | 665 | ||
| SUGGESTED READING | 666 | ||
| PART III: Drugs and Symptoms | 667 | ||
| SECTION A: Drugs | 668 | ||
| CHAPTER 121: Principles of Pharmacology | 668 | ||
| PHARMACOKINETICS | 668 | ||
| PHARMACODYNAMICS | 671 | ||
| SUGGESTED READING | 674 | ||
| CHAPTER 122: Neuropharmacology and Psychopharmacology | 675 | ||
| ANTIPSYCHOTIC DRUGS | 675 | ||
| ANTIDEPRESSANTS | 679 | ||
| g-AMINOBUTYRIC ACID AGONISTS | 683 | ||
| REFERENCES | 686 | ||
| CHAPTER 123: Prescribing | 687 | ||
| QUALITY PRESCRIBING | 687 | ||
| POLYPHARMACY | 687 | ||
| MEDICATION ADHERENCE | 689 | ||
| OFF-LABEL AND UNLICENSED MEDICINES | 689 | ||
| REFERENCES | 691 | ||
| SUGGESTED READING | 691 | ||
| CHAPTER 124: Interactions, Side Effects, and Management | 692 | ||
| PRINCIPLES OF DRUG INTERACTIONS | 692 | ||
| PHARMACOKINETIC DRUG INTERACTIONS | 692 | ||
| PHARMACODYNAMIC DRUG INTERACTIONS | 693 | ||
| CONCLUSION | 695 | ||
| REFERENCES | 695 | ||
| CHAPTER 125: Drug Use in Special Populations | 696 | ||
| GERIATRIC CLINICAL PHARMACOLOGY | 696 | ||
| DRUG TREATMENT IN CHILDREN | 698 | ||
| DRUGS AND PREGNANCY | 698 | ||
| CONCLUSIONS | 699 | ||
| EVIDENCE-BASED MEDICINE | 699 | ||
| REFERENCES | 699 | ||
| SUGGESTED READING | 700 | ||
| CHAPTER 126: Kidney and Liver Disease | 700 | ||
| ASSESSMENT OF KIDNEY FUNCTION | 700 | ||
| ASSESSMENT OF LIVER FUNCTION | 700 | ||
| MECHANISMS OF ACTION | 701 | ||
| DOSAGES | 703 | ||
| MAJOR SIDE EFFECTS | 704 | ||
| CONTRAINDICATIONS | 704 | ||
| DRUG INTERACTIONS | 704 | ||
| RESEARCH CHALLENGES | 704 | ||
| REFERENCES | 705 | ||
| SUGGESTED READING | 706 | ||
| CHAPTER 127: Routes of Administration | 706 | ||
| ORAL ROUTE | 706 | ||
| BUCCAL AND SUBLINGUAL ADMINISTRATION | 706 | ||
| NASOGASTRIC AND ENTERAL FEEDING TUBES | 707 | ||
| RECTAL ROUTE | 707 | ||
| TRANSDERMAL ROUTE | 707 | ||
| PARENTERAL ROUTES | 707 | ||
| SPINAL ROUTE | 709 | ||
| CONCLUSIONS | 710 | ||
| REFERENCES | 710 | ||
| SUGGESTED READING | 711 | ||
| CHAPTER 128: Development and Use of a Formulary | 711 | ||
| EVIDENCE-BASED PATIENT CARE | 711 | ||
| THE FORMULARY PROCESS | 712 | ||
| EVIDENCE-BASED RESOURCES | 714 | ||
| CONCLUSIONS | 715 | ||
| REFERENCES | 715 | ||
| CHAPTER 129: Antacids | 715 | ||
| ANTACID SALTS | 716 | ||
| HISTAMINE2 RECEPTOR ANTAGONISTS | 716 | ||
| PROTON PUMP INHIBITORS | 717 | ||
| SUCRALFATE | 718 | ||
| EVIDENCE-BASED MEDICINE | 718 | ||
| RESEARCH CHALLENGES | 718 | ||
| REFERENCES | 719 | ||
| CHAPTER 130: Antidepressants and Psychostimulants | 719 | ||
| MECHANISMS OF ACTION AND CONTRAINDICATIONS | 719 | ||
| DOSAGES | 721 | ||
| MAJOR SIDE EFFECTS | 721 | ||
| REFERENCES | 722 | ||
| SUGGESTED READING | 722 | ||
| CHAPTER 131: Antibiotics | 723 | ||
| CHLOROPHYLL | 723 | ||
| METRONIDAZOLE | 725 | ||
| RESEARCH CHALLENGES | 726 | ||
| REFERENCES | 726 | ||
| SUGGESTED READING | 726 | ||
| CHAPTER 132: Antiepileptic Drugs | 726 | ||
| INDICATIONS FOR ANTIEPILEPTIC DRUGS | 727 | ||
| DOCUMENTED SEIZURES | 727 | ||
| PROPHYLAXIS OF SEIZURES | 727 | ||
| MECHANISMS OF ACTION | 727 | ||
| PHARMACOKINETICS | 727 | ||
| DOSING AND ADMINISTRATION | 727 | ||
| MAJOR SIDE EFFECTS | 730 | ||
| CONTRAINDICATIONS | 730 | ||
| DRUG INTERACTIONS | 730 | ||
| REFERENCES | 731 | ||
| SUGGESTED READING | 731 | ||
| CHAPTER 133: Cancer-Related Weight Loss | 732 | ||
| PHARMACOLOGICAL INTERVENTION—IDENTIFICATION OF THE TREATABLE PROBLEM | 732 | ||
| RESEARCH CHALLENGES | 733 | ||
| FUTURE CONSIDERATIONS | 735 | ||
| REFERENCES | 736 | ||
| SUGGESTED READING | 736 | ||
| CHAPTER 134: Anxiolytics, Sedatives, and Hypnotics | 736 | ||
| BENZODIAZEPINES | 736 | ||
| NONBENZODIAZEPINE SEDATIVES—THE Z-DRUGS | 738 | ||
| MISCELLANEOUS AGENTS | 739 | ||
| CONCLUSIONS | 740 | ||
| REFERENCES | 740 | ||
| CHAPTER 135: Nonsteroidal Anti-inflammatory Drugs | 740 | ||
| MECHANISMS OF ACTION | 740 | ||
| PHARMACOLOGICAL DIFFERENCES | 741 | ||
| SELECTION OF DRUGS FOR CANCER-RELATED PAIN | 743 | ||
| DOSAGE | 743 | ||
| MAJOR SIDE EFFECTS | 743 | ||
| CONTRAINDICATIONS | 743 | ||
| DRUG INTERACTIONS | 743 | ||
| RESEARCH CHALLENGES | 743 | ||
| EVIDENCE-BASED MEDICINE | 745 | ||
| REFERENCES | 745 | ||
| CHAPTER 136: Diuretics | 745 | ||
| MECHANISM OF ACTION | 745 | ||
| DOSAGES | 747 | ||
| MAJOR SIDE EFFECTS | 748 | ||
| CONTRAINDICATIONS | 749 | ||
| REFERENCES | 749 | ||
| CHAPTER 137: Bronchodilators and Cough Suppressants | 749 | ||
| ANTITUSSIVES | 750 | ||
| BRONCHODILATORS | 751 | ||
| SUMMARY | 753 | ||
| REFERENCES | 753 | ||
| CHAPTER 138: Opioids | 754 | ||
| MECHANISM OF ACTION | 754 | ||
| DOSAGES | 754 | ||
| MAJOR SIDE EFFECTS | 754 | ||
| CONTRAINDICATIONS | 755 | ||
| DRUG INTERACTIONS | 755 | ||
| RESEARCH CHALLENGES | 755 | ||
| TRAMADOL | 755 | ||
| CODEINE | 756 | ||
| MORPHINE | 756 | ||
| DIAMORPHINE | 757 | ||
| HYDROMORPHONE | 757 | ||
| FENTANYL | 757 | ||
| OXYCODONE | 757 | ||
| METHADONE | 758 | ||
| BUPRENORPHINE | 758 | ||
| REFERENCES | 759 | ||
| SUGGESTED READING | 759 | ||
| CHAPTER 139: Psychotropic Drugs | 759 | ||
| CHLORPROMAZINE | 760 | ||
| METHOTRIMEPRAZINE (LEVOMEPROMAZINE) | 761 | ||
| THIORIDAZINE | 762 | ||
| HALOPERIDOL | 762 | ||
| OLANZAPINE | 763 | ||
| RISPERIDONE | 764 | ||
| CANNABINOIDS | 765 | ||
| REFERENCES | 766 | ||
| CHAPTER 140: Laxatives | 767 | ||
| REFERENCES | 770 | ||
| SUGGESTED READING | 770 | ||
| CHAPTER 141: Cardiac Drugs | 771 | ||
| GLYCERYL TRINITRATE | 771 | ||
| DOPAMINE | 772 | ||
| MEXILETINE | 772 | ||
| LIDOCAINE | 773 | ||
| WARFARIN SODIUM (COUMADIN) | 774 | ||
| HEPARINS | 775 | ||
| REFERENCES | 776 | ||
| CHAPTER 142: Local and General Anesthetics | 777 | ||
| LOCAL ANESTHETICS AND PALLIATIVE CARE | 777 | ||
| GENERAL ANESTHETICS AND PALLIATIVE CARE | 779 | ||
| REFERENCES | 781 | ||
| SUGGESTED READING | 781 | ||
| CHAPTER 143: Drugs for Hypercalcemia | 781 | ||
| PATHOGENESIS OF CANCER HYPERCALCEMIA AND MECHANISM OF ACTION OF BISPHOSPHONATES | 782 | ||
| BISPHOSPHONATES FOR HYPERCALCEMIA | 782 | ||
| OTHER DRUGS FOR HYPERCALCEMIA | 783 | ||
| THE CHALLENGE OF RENAL INSUFFICIENCY | 784 | ||
| PREVENTION OF TUMOR-INDUCED HYPERCALCEMIA | 784 | ||
| REFERENCES | 784 | ||
| SUGGESTED READING | 785 | ||
| CHAPTER 144: Antiemetic Drugs | 785 | ||
| APREPITANT | 785 | ||
| CHLORPROMAZINE | 786 | ||
| CISAPRIDE | 788 | ||
| CYCLIZINE | 788 | ||
| DEXAMETHASONE | 789 | ||
| DOMPERIDONE | 790 | ||
| HALOPERIDOL | 790 | ||
| HYOSCINE | 791 | ||
| LEVOMEPROMAZINE | 791 | ||
| LORAZEPAM | 791 | ||
| METOCLOPRAMIDE | 792 | ||
| NABILONE | 792 | ||
| OCTREOTIDE | 793 | ||
| OLANZAPINE | 793 | ||
| PROCHLORPERAZINE | 794 | ||
| PROMETHAZINE | 794 | ||
| 5-HT3 ANTAGONISTS | 795 | ||
| REFERENCES | 796 | ||
| SUGGESTED READING | 796 | ||
| CHAPTER 145: Corticosteroids | 797 | ||
| MECHANISM OF ACTION | 797 | ||
| DOSAGES | 798 | ||
| MAJOR SIDE EFFECTS | 798 | ||
| CORTICOSTEROIDS IN TERMINAL PHASE | 799 | ||
| CONTRAINDICATIONS | 799 | ||
| DRUG INTERACTIONS | 799 | ||
| EVIDENCE-BASED MEDICINE | 799 | ||
| RESEARCH CHALLENGES | 801 | ||
| REFERENCES | 801 | ||
| CHAPTER 146: Drugs for Myoclonus and Tremors | 801 | ||
| MECHANISM OF ACTION | 802 | ||
| PHARMACOKINETICS | 802 | ||
| DOSING AND ADMINISTRATION | 803 | ||
| MAJOR SIDE EFFECTS | 803 | ||
| CONTRAINDICATIONS | 805 | ||
| DRUG INTERACTIONS | 805 | ||
| REFERENCES | 805 | ||
| SUGGESTED READING | 805 | ||
| CHAPTER 147: Drugs for Diarrhea | 806 | ||
| OPIOIDS | 806 | ||
| ANTICHOLINERGICS/ANTISPASMODICS | 808 | ||
| BILE ACID RESIN | 809 | ||
| ABSORBENT BULK FORMING | 809 | ||
| ANTI-INFECTIVE AGENTS/XENOBIOTICS | 810 | ||
| ANTI-INFECTIVES | 810 | ||
| ANTISECRETORY AGENTS | 811 | ||
| REFERENCES | 812 | ||
| SUGGESTED READING | 812 | ||
| SECTION B: Symptom Control | 813 | ||
| CHAPTER 148: Principles of Symptom Control | 813 | ||
| THE PRIMACY OF THE SYMPTOM | 813 | ||
| PREVALENCE OF SYMPTOMS IN ADVANCED DISEASE | 813 | ||
| CLINICAL MANIFESTATIONS: EVALUATION AND ASSESSMENT | 813 | ||
| TREATMENT | 815 | ||
| DEVELOPMENTS AND CONTROVERSIES IN PALLIATIVE CARE | 820 | ||
| REFERENCES | 820 | ||
| SUGGESTED READING | 821 | ||
| CHAPTER 149: Symptom Epidemiology and Clusters | 821 | ||
| SYMPTOM EPIDEMIOLOGY | 821 | ||
| SYMPTOM CLUSTERS | 824 | ||
| RESEARCH OPPORTUNITIES | 825 | ||
| REFERENCES | 825 | ||
| SUGGESTED READING | 826 | ||
| CHAPTER 150: Anorexia and Weight Loss | 826 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 826 | ||
| EPIDEMIOLOGY AND PREVALENCE | 826 | ||
| CLINICAL MANIFESTATIONS | 826 | ||
| EVALUATION | 828 | ||
| DIFFERENTIAL DIAGNOSIS | 831 | ||
| TREATMENT | 831 | ||
| RESEARCH OPPORTUNITIES | 833 | ||
| REFERENCES | 833 | ||
| SUGGESTED READING | 833 | ||
| CHAPTER 151: Anxiety | 833 | ||
| BASIC SCIENCE | 833 | ||
| EPIDEMIOLOGY AND PREVALENCE | 834 | ||
| CLINICAL MANIFESTATIONS | 834 | ||
| DIFFERENTIAL DIAGNOSIS | 835 | ||
| TREATMENT | 836 | ||
| CONCLUSIONS AND RESEARCH OPPORTUNITIES | 836 | ||
| REFERENCES | 836 | ||
| CHAPTER 152: Syncope and Blackouts | 837 | ||
| EPIDEMIOLOGY AND PATHOPHYSIOLOGY | 837 | ||
| CLINICAL MANIFESTATIONS | 840 | ||
| TREATMENT | 840 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 841 | ||
| REFERENCES | 841 | ||
| SUGGESTED READING | 841 | ||
| CHAPTER 153: Airway Obstruction | 842 | ||
| DEFINITIONS | 842 | ||
| PATHOPHYSIOLOGY AND EPIDEMIOLOGY | 842 | ||
| CLINICAL MANIFESTATIONS | 842 | ||
| DIFFERENTIAL DIAGNOSIS | 842 | ||
| TREATMENT | 842 | ||
| RESEARCH OPPORTUNITIES | 846 | ||
| REFERENCES | 846 | ||
| SUGGESTED READING | 846 | ||
| CHAPTER 154: Constipation and Diarrhea | 846 | ||
| CONSTIPATION | 846 | ||
| DIARRHEA | 851 | ||
| TREATMENT | 853 | ||
| RESEARCH OPPORTUNITIES | 853 | ||
| REFERENCES | 853 | ||
| SUGGESTED READING | 854 | ||
| CHAPTER 155: Cough, Hemoptysis, and Bronchorrhea | 854 | ||
| COUGH | 854 | ||
| HEMOPTYSIS | 856 | ||
| BRONCHORRHEA | 858 | ||
| RESEARCH OPPORTUNITIES | 858 | ||
| REFERENCES | 859 | ||
| CHAPTER 156: Delirium and Psychosis | 860 | ||
| DEFINITION | 860 | ||
| EPIDEMIOLOGY, PREVALENCE, AND RISK FACTORS | 860 | ||
| PATHOPHYSIOLOGY | 861 | ||
| CLINICAL MANIFESTATIONS | 861 | ||
| SCREENING: DIAGNOSTIC INSTRUMENTS | 861 | ||
| DIFFERENTIAL DIAGNOSIS | 862 | ||
| TREATMENT | 863 | ||
| CONTROVERSIES AND RESEARCH OPPORTUNITIES | 864 | ||
| REFERENCES | 864 | ||
| SUGGESTED READING | 865 | ||
| CHAPTER 157: Depression | 865 | ||
| BASIC SCIENCE | 865 | ||
| EPIDEMIOLOGY AND PREVALENCE | 865 | ||
| GENETICS | 865 | ||
| PATHOPHYSIOLOGY | 865 | ||
| CLINICAL MANIFESTATIONS | 866 | ||
| ASSOCIATED MEDICAL CONDITIONS | 866 | ||
| TREATMENT | 868 | ||
| EVIDENCE-BASED MEDICINE AND RESEARCH OPPORTUNITIES | 868 | ||
| CONCLUSIONS | 870 | ||
| REFERENCES | 870 | ||
| SUGGESTED READING | 871 | ||
| CHAPTER 158: Dysphagia | 871 | ||
| BASIC SCIENCE | 871 | ||
| EPIDEMIOLOGY AND PREVALENCE | 871 | ||
| CLINICAL MANIFESTATIONS | 872 | ||
| DIFFERENTIAL DIAGNOSIS | 873 | ||
| TREATMENT | 875 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 876 | ||
| CONCLUSIONS | 876 | ||
| REFERENCES | 876 | ||
| SUGGESTED READING | 877 | ||
| CHAPTER 159: Dyspnea | 877 | ||
| EPIDEMIOLOGY AND PREVALENCE | 877 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 877 | ||
| CLINICAL MANIFESTATIONS | 878 | ||
| DIFFERENTIAL DIAGNOSIS | 878 | ||
| TREATMENT | 879 | ||
| EVIDENCE-BASED MEDICINE AND RESEARCH OPPORTUNITIES | 880 | ||
| REFERENCES | 880 | ||
| SUGGESTED READING | 881 | ||
| CHAPTER 160: Edema | 881 | ||
| DEFINITION | 881 | ||
| BASIC SCIENCE | 881 | ||
| EPIDEMIOLOGY AND PREVALENCE | 882 | ||
| PATHOPHYSIOLOGY | 882 | ||
| CLINICAL MANIFESTATIONS | 882 | ||
| TREATMENT | 884 | ||
| MANAGEMENT FLOW CHART | 885 | ||
| REFERENCES | 886 | ||
| SUGGESTED READING | 886 | ||
| CHAPTER 161: Fatigue | 886 | ||
| BASIC SCIENCE | 887 | ||
| EPIDEMIOLOGY AND PREVALENCE | 887 | ||
| CLINICAL MANIFESTATIONS | 887 | ||
| TREATMENT | 889 | ||
| SUMMARY | 889 | ||
| REFERENCES | 890 | ||
| CHAPTER 162: Fever and Sweats | 890 | ||
| FEVER | 890 | ||
| SWEATS | 892 | ||
| CONCLUSIONS | 893 | ||
| REFERENCES | 893 | ||
| SUGGESTED READING | 893 | ||
| CHAPTER 163: Hiccups | 894 | ||
| BASIC SCIENCE | 894 | ||
| EPIDEMIOLOGY AND PATHOPHYSIOLOGY | 894 | ||
| MANAGEMENT | 896 | ||
| CONCLUSIONS | 897 | ||
| REFERENCES | 898 | ||
| SUGGESTED READING | 898 | ||
| CHAPTER 164: Incontinence: Urine and Stool | 898 | ||
| URINARY INCONTINENCE | 899 | ||
| FECAL INCONTINENCE | 903 | ||
| REFERENCES | 904 | ||
| SUGGESTED READING | 904 | ||
| CHAPTER 165: Indigestion | 905 | ||
| DYSPEPSIA | 905 | ||
| HEARTBURN | 907 | ||
| BLOATING | 908 | ||
| BELCHING | 909 | ||
| REFERENCES | 910 | ||
| CHAPTER 166: Pruritus | 910 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 910 | ||
| CLINICAL MANIFESTATIONS | 911 | ||
| DIFFERENTIAL DIAGNOSIS | 911 | ||
| TREATMENT | 912 | ||
| SUPPORTIVE CARE | 912 | ||
| REFERENCES | 913 | ||
| SUGGESTED READING | 913 | ||
| CHAPTER 167: Memory Problems | 913 | ||
| EPIDEMIOLOGY | 914 | ||
| PATHOPHYSIOLOGY | 914 | ||
| CLINICAL MANIFESTATIONS | 914 | ||
| DIFFERENTIAL DIAGNOSIS | 915 | ||
| TREATMENT | 915 | ||
| SUPPORTIVE CARE | 915 | ||
| REFERENCES | 915 | ||
| CHAPTER 168: Muscle Spasms | 916 | ||
| MUSCLE SPASM | 916 | ||
| MYOCLONUS | 917 | ||
| TREMOR | 919 | ||
| REFERENCES | 921 | ||
| CHAPTER 169: Nausea, Vomiting, and Early Satiety | 921 | ||
| PREVALENCE AND EPIDEMIOLOGY | 922 | ||
| PATHOPHYSIOLOGY | 922 | ||
| DIFFERENTIAL DIAGNOSIS | 923 | ||
| TREATMENT | 925 | ||
| REFERENCES | 930 | ||
| SUGGESTED READING | 931 | ||
| CHAPTER 170: Nonmalignant Pain | 931 | ||
| BASIC SCIENCE | 931 | ||
| PREVALENCE OF NONMALIGNANT PAIN | 932 | ||
| PATHOPHYSIOLOGY AND PAIN “DIAGNOSIS” | 932 | ||
| CLINICAL MANIFESTATIONS OF COMMON CONDITIONS | 933 | ||
| DIFFERENTIAL DIAGNOSIS | 935 | ||
| TREATMENT | 935 | ||
| OUTCOMES OF PAIN MANAGEMENT | 935 | ||
| DRUGS OF CHOICE | 935 | ||
| EVIDENCE-BASED MEDICINE | 936 | ||
| CONCLUSION | 936 | ||
| REFERENCES | 936 | ||
| SUGGESTED READING | 937 | ||
| CHAPTER 171: Oral Symptoms | 937 | ||
| DRY MOUTH | 937 | ||
| SORE MOUTH AND STOMATODYNIA | 939 | ||
| TASTE CHANGES | 944 | ||
| REFERENCES | 946 | ||
| SUGGESTED READING | 946 | ||
| CHAPTER 172: Tenesmus, Strangury, and Malodor | 946 | ||
| TENESMUS | 946 | ||
| STRANGURY | 948 | ||
| MALODOR | 949 | ||
| REFERENCES | 950 | ||
| SUGGESTED READING | 950 | ||
| CHAPTER 173: Premature Menopause | 950 | ||
| PREVALENCE OF PREMATURE MENOPAUSE AND ASSOCIATED SYMPTOMS | 951 | ||
| HOT FLASHES | 951 | ||
| BONE LOSS | 953 | ||
| SEXUAL FUNCTION | 953 | ||
| SUMMARY | 954 | ||
| REFERENCES | 954 | ||
| SUGGESTED READING | 955 | ||
| CHAPTER 174: Death Rattle | 956 | ||
| BASIC SCIENCE | 956 | ||
| EPIDEMIOLOGY | 956 | ||
| PATHOPHYSIOLOGY | 956 | ||
| CLINICAL MANIFESTATIONS AND DIFFERENTIAL DIAGNOSIS | 957 | ||
| TREATMENT | 958 | ||
| EVIDENCE-BASED MEDICINE | 960 | ||
| REFERENCES | 960 | ||
| SUGGESTED READING | 960 | ||
| CHAPTER 175: Seizures and Movement Disorders | 961 | ||
| SEIZURES | 961 | ||
| MYOCLONUS | 962 | ||
| NEUROLEPTIC-INDUCED MOVEMENT DISORDERS | 963 | ||
| REFERENCES | 964 | ||
| SUGGESTED READING | 965 | ||
| CHAPTER 176: Sleep Problems and Nightmares | 965 | ||
| BASIC SCIENCE | 965 | ||
| EPIDEMIOLOGY AND PREVALENCE | 966 | ||
| PATHOPHYSIOLOGY | 966 | ||
| CLINICAL MANIFESTATIONS | 966 | ||
| DIFFERENTIAL DIAGNOSIS | 966 | ||
| TREATMENT | 967 | ||
| EVIDENCE-BASED MEDICINE | 969 | ||
| REFERENCES | 971 | ||
| SECTION C: Care of the Imminently Dying | 973 | ||
| CHAPTER 177: Diagnosis of Death and Dying | 973 | ||
| CLINICAL EVALUATION | 973 | ||
| DEATH | 975 | ||
| ASSESSMENT TOOLS | 976 | ||
| ACUTE MANAGEMENT | 976 | ||
| COMMON ERRORS | 976 | ||
| LINKED AREAS | 976 | ||
| RESEARCH CHALLENGES AND PRIORITIES | 977 | ||
| CONCLUSIONS | 977 | ||
| REFERENCES | 977 | ||
| SUGGESTED READING | 978 | ||
| CHAPTER 178: Standards of Care | 978 | ||
| ANTICIPATORY PROCESS STANDARDS OF CARE FOR THE DYING | 978 | ||
| CONTINUOUS QUALITY IMPROVEMENT PROGRAM FOR SETTING STANDARDS OF CARE FOR THE DYING | 979 | ||
| SETTING STANDARDS OF CARE FOR THE DYING: USING THE VIEWS OF BEREAVED RELATIVES | 980 | ||
| FUTURE RESEARCH GOALS | 982 | ||
| REFERENCES | 982 | ||
| SUGGESTED READING | 983 | ||
| CHAPTER 179: Palliative Sedation | 983 | ||
| PRINCIPLES OF ASSESSMENT AND MANAGEMENT | 983 | ||
| ETHICAL CONSIDERATIONS | 984 | ||
| ACUTE MANAGEMENT | 984 | ||
| REFERENCES | 987 | ||
| SUGGESTED READING | 987 | ||
| CHAPTER 180: Care of the Dying: Hospitals and Intensive Care Units | 988 | ||
| PRINCIPLES OF ASSESSMENT AND MEASUREMENT | 989 | ||
| CLINICAL ASSESSMENT AND DIAGNOSIS | 989 | ||
| MANAGEMENT | 991 | ||
| CHALLENGES FOR INTENSIVE CARE | 993 | ||
| EDUCATION AND CONTINUING MEDICAL EDUCATION | 993 | ||
| FAMILY | 995 | ||
| ECONOMICS | 995 | ||
| ETHICS: THE INCAPACITY ELEMENT | 995 | ||
| THE SWITCH FROM INTENSIVE CARE TO PALLIATION | 995 | ||
| CONCLUSION | 996 | ||
| REFERENCES | 996 | ||
| CHAPTER 181: Comfort Care: Symptom Control in the Dying | 997 | ||
| CLINICAL EVALUATION AND DIAGNOSIS | 997 | ||
| SYMPTOM MANAGEMENT | 998 | ||
| TERMINAL EMERGENCIES | 999 | ||
| PSYCHOSOCIAL CARE | 999 | ||
| COMMON ERRORS | 999 | ||
| RESEARCH CHALLENGES | 1000 | ||
| CONCLUSIONS | 1000 | ||
| REFERENCES | 1000 | ||
| SUGGESTED READING | 1000 | ||
| SECTION D: Complementary and Alternative Medicines | 1001 | ||
| CHAPTER 182: Integrative Medicine: Complementary Therapies | 1001 | ||
| DEFINITIONS AND OVERVIEW | 1001 | ||
| COMPLEMENTARY AND ALTERNATIVE THERAPIES IN MEDICAL PRACTICE | 1001 | ||
| ALTERNATIVE THERAPIES | 1002 | ||
| COMPLEMENTARY THERAPIES | 1003 | ||
| CONCLUSIONS | 1005 | ||
| REFERENCES | 1005 | ||
| PART IV: Palliative Care and General Medicine | 1007 | ||
| SECTION A: Complex Illnesses | 1008 | ||
| CHAPTER 183: Organ Transplantation | 1008 | ||
| EPIDEMIOLOGY AND DONOR ISSUES | 1008 | ||
| RECIPIENT EVALUATION | 1009 | ||
| ORGAN ALLOCATION | 1009 | ||
| THE TRANSPLANTATION PROCEDURE | 1010 | ||
| IMMUNOSUPPRESSION | 1010 | ||
| EARLY AND LONG-TERM COMPLICATIONS | 1011 | ||
| TRANSPLANTATION AND PALLIATIVE CARE | 1012 | ||
| REFERENCES | 1012 | ||
| CHAPTER 184: Cardiovascular Disorders | 1012 | ||
| BASIC SCIENCE | 1012 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1013 | ||
| PATHOPHYSIOLOGY | 1013 | ||
| CLINICAL MANIFESTATIONS | 1014 | ||
| TREATMENT | 1014 | ||
| RESEARCH OPPORTUNITIES | 1015 | ||
| REFERENCES | 1016 | ||
| SUGGESTED READING | 1016 | ||
| CHAPTER 185: Respiratory Failure | 1016 | ||
| BASIC SCIENCE | 1017 | ||
| PATHOPHYSIOLOGY | 1017 | ||
| CLINICAL MANIFESTATIONS | 1017 | ||
| DIFFERENTIAL DIAGNOSIS | 1018 | ||
| MANAGEMENT | 1019 | ||
| CONTROVERSIES AND RESEARCH OPPORTUNITIES | 1021 | ||
| REFERENCES | 1021 | ||
| SUGGESTED READING | 1021 | ||
| CHAPTER 186: Respiratory Equipment | 1021 | ||
| INDICATIONS FOR OXYGEN THERAPY | 1021 | ||
| HIGH-FLOW AND LOW-FLOW DEVICES FOR OXYGEN DELIVERY | 1022 | ||
| REFERENCES | 1026 | ||
| SECTION B: Nervous System and Musculoskeletal Disorders | 1027 | ||
| CHAPTER 187: Congenital Intellectual Disability | 1027 | ||
| EPIDEMIOLOGY AND PATHOPHYSIOLOGY OF INTELLECTUAL DISABILITY | 1027 | ||
| ISSUES OF CONSENT AND CAPACITY | 1028 | ||
| ISSUES OF STAFF SUPPORT | 1031 | ||
| BEREAVEMENT | 1032 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 1032 | ||
| REFERENCES | 1033 | ||
| SUGGESTED READING | 1033 | ||
| CHAPTER 188: Musculoskeletal Disorders | 1033 | ||
| OSTEOARTHRITIS | 1033 | ||
| OSTEOPOROSIS | 1035 | ||
| CHRONIC INFLAMMATORY JOINT DISEASES | 1036 | ||
| SYSTEMIC SCLEROSIS | 1038 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 1039 | ||
| REFERENCES | 1039 | ||
| CHAPTER 189: Stroke | 1040 | ||
| EPIDEMIOLOGY, PATHOPHYSIOLOGY, AND OUTCOMES | 1040 | ||
| IDENTIFICATION, DIAGNOSIS, AND TREATMENT | 1041 | ||
| MANAGEMENT | 1042 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 1043 | ||
| REFERENCES | 1043 | ||
| CHAPTER 190: Parkinson’s Disease | 1044 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1045 | ||
| PATHOPHYSIOLOGY AND BASIC SCIENCE | 1045 | ||
| CLINICAL MANIFESTATIONS | 1046 | ||
| DIFFERENTIAL DIAGNOSIS | 1047 | ||
| TREATMENT | 1048 | ||
| SUPPORTIVE CARE | 1053 | ||
| EVIDENCE-BASED MEDICINE | 1053 | ||
| REFERENCES | 1053 | ||
| SUGGESTED READING | 1054 | ||
| CHAPTER 191: Multiple Sclerosis | 1055 | ||
| PATHOPHYSIOLOGY | 1055 | ||
| EPIDEMIOLOGY, PREVALENCE, AND DISEASE COURSE | 1055 | ||
| CLINICAL MANIFESTATIONS | 1056 | ||
| DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS | 1056 | ||
| TREATMENT | 1057 | ||
| PALLIATIVE CARE | 1061 | ||
| DEVELOPMENTS AND RESEARCH OPPORTUNITIES | 1061 | ||
| ACKNOWLEDGMENTS | 1061 | ||
| REFERENCES | 1061 | ||
| SUGGESTED READING | 1061 | ||
| CHAPTER 192: Amyotrophic Lateral Sclerosis | 1062 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1062 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 1062 | ||
| CLINICAL MANIFESTATIONS | 1062 | ||
| DIAGNOSIS | 1063 | ||
| DIFFERENTIAL DIAGNOSIS | 1063 | ||
| TREATMENT | 1063 | ||
| REFERENCES | 1066 | ||
| SUGGESTED READING | 1067 | ||
| CHAPTER 193: Quadriplegia and Paraplegia | 1067 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1067 | ||
| PATHOPHYSIOLOGY | 1067 | ||
| CLINICAL MANIFESTATIONS | 1068 | ||
| REFERENCES | 1070 | ||
| SECTION C: Pediatrics | 1071 | ||
| CHAPTER 194: Neonates, Children, and Adolescents | 1071 | ||
| ESSENTIAL ELEMENTS IN PEDIATRIC PALLIATIVE CARE | 1071 | ||
| BARRIERS TO PALLIATIVE CARE IN CHILDREN | 1075 | ||
| PSYCHOSOCIAL ASPECTS OF SERIOUS ILLNESS AND DEATH IN CHILDHOOD AND ADOLESCENCE | 1077 | ||
| INVOLVING CHILDREN AND ADOLESCENTS IN ADVANCED CARE | 1078 | ||
| SUMMARY | 1078 | ||
| REFERENCES | 1079 | ||
| CHAPTER 195: Cancer in Children | 1079 | ||
| ETIOLOGY | 1081 | ||
| CLINICAL MANIFESTATIONS | 1081 | ||
| PRINCIPLES OF TREATMENT | 1082 | ||
| PALLIATIVE CARE OF THE DYING CHILD | 1083 | ||
| REFERENCES | 1084 | ||
| SUGGESTED READING | 1085 | ||
| CHAPTER 196: Psychological Adaptation of the Dying Child | 1085 | ||
| THE CHILD’S UNDERSTANDING OF ILLNESS AND DEATH | 1085 | ||
| THE CHILD’S PSYCHOLOGICAL SUFFERING | 1088 | ||
| THE FAMILY’S PSYCHOLOGICAL SUFFERING | 1089 | ||
| COMMUNICATION WITH THE CHILD AND FAMILY | 1090 | ||
| DECISION MAKING WITH THE CHILD AND FAMILY | 1091 | ||
| SPIRITUAL SUPPORT FOR THE CHILD AND FAMILY | 1092 | ||
| REFERENCES | 1092 | ||
| CHAPTER 197: Family Adjustment and Support | 1093 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1094 | ||
| CLINICAL MANIFESTATIONS | 1094 | ||
| DIFFERENTIAL DIAGNOSES | 1094 | ||
| TREATMENT | 1095 | ||
| REFERENCES | 1096 | ||
| ADDITIONAL RESOURCES | 1097 | ||
| CHAPTER 198: Pediatric Pain and Symptom Control | 1097 | ||
| SPECIAL ISSUES IN PEDIATRIC PALLIATIVE CARE | 1097 | ||
| APPROACH TO PEDIATRIC PALLIATIVE CARE | 1097 | ||
| CLINICAL ASSESSMENT OF SYMPTOMS | 1098 | ||
| MANAGEMENT OF SYMPTOMS | 1098 | ||
| REFERENCES | 1104 | ||
| SUGGESTED READING | 1105 | ||
| CHAPTER 199: Hospice and Special Services | 1105 | ||
| DECISION MAKING IN PEDIATRIC PALLIATIVE CARE | 1106 | ||
| EPIDEMIOLOGY, PREVALENCE, AND NEED | 1106 | ||
| LOCATION OF DEATH: A SYMPTOM OF THE PROBLEM | 1107 | ||
| DIAGNOSTIC AND PROGNOSTIC UNCERTAINTY | 1107 | ||
| FAMILY SUPPORT | 1107 | ||
| LEGAL AND ETHICAL ISSUES AND THE CARE OF CHILDREN: PERMISSION, ASSENT, AND CONSENT | 1107 | ||
| DESIGNING AN INTEGRATED MODEL: THE MEDICAL HOME AND PEDIATRIC PALLIATIVE CARE MODEL | 1108 | ||
| CONTINUUM OF CARE | 1109 | ||
| REFERENCES | 1109 | ||
| SUGGESTED READING | 1110 | ||
| CHAPTER 200: Pediatric Palliative Care: Interdisciplinary Support | 1110 | ||
| GOALS OF CARE: THE FRAMEWORK | 1110 | ||
| RECENT DEVELOPMENTS | 1111 | ||
| CONCLUSIONS AND CONTROVERSIES | 1113 | ||
| RESEARCH CHALLENGES, OPPORTUNITIES, AND ADVANCES | 1114 | ||
| REFERENCES | 1114 | ||
| SUGGESTED READING | 1114 | ||
| CHAPTER 201: Parent and Child Bereavement | 1115 | ||
| THE NATURE OF CHILDREN’S GRIEF REACTIONS | 1115 | ||
| PSYCHOSOCIAL RISK FACTORS | 1116 | ||
| PSYCHOSOCIAL PROTECTIVE FACTORS | 1116 | ||
| BEREAVEMENT INTERVENTIONS IN PALLIATIVE MEDICINE AND HOSPICE | 1116 | ||
| ORGANIZATIONAL SUPPORT FOR BEREAVEMENT COUNSELING | 1118 | ||
| SUMMARY | 1118 | ||
| REFERENCES | 1118 | ||
| SUGGESTED READING | 1119 | ||
| SECTION D: Geriatrics | 1120 | ||
| CHAPTER 202: Demographics of Aging | 1120 | ||
| DEMOGRAPHIC TRENDS | 1120 | ||
| LIFE EXPECTANCY | 1120 | ||
| DEPENDENCY RATIO | 1120 | ||
| MORTALITY | 1120 | ||
| IMPLICATIONS OF AGING IN HEALTH CARE | 1122 | ||
| PALLIATIVE CARE AND AGING | 1122 | ||
| REFERENCES | 1123 | ||
| CHAPTER 203: Biology and Physiology of Aging | 1123 | ||
| TWO TYPES OF THEORIES OF AGING | 1124 | ||
| CARDIOVASCULAR SYSTEM | 1124 | ||
| RESPIRATORY SYSTEM | 1125 | ||
| RENAL SYSTEM | 1126 | ||
| GASTROINTESTINAL AND HEPATOBILIARY SYSTEMS | 1126 | ||
| ENDOCRINE AND IMMUNE SYSTEMS | 1127 | ||
| NEUROLOGICAL SYSTEM | 1128 | ||
| SUMMARY | 1129 | ||
| REFERENCES | 1129 | ||
| CHAPTER 204: The Aging Brain and Dementia | 1130 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 1130 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1130 | ||
| CLINICAL MANIFESTATIONS | 1130 | ||
| TREATMENT AND END-OF-LIFE DECISIONS IN DEMENTIA | 1131 | ||
| SUMMARY | 1132 | ||
| REFERENCES | 1132 | ||
| SUGGESTED READING | 1132 | ||
| CHAPTER 205: The Frail Elderly | 1132 | ||
| EPIDEMIOLOGY | 1133 | ||
| CLINICAL MANIFESTATIONS | 1133 | ||
| DIFFERENTIAL DIAGNOSIS: FRAILTY, DISABILITY, AND COMORBIDITY | 1136 | ||
| BASIC SCIENCE AND PATHOPHYSIOLOGY | 1136 | ||
| MOLECULAR MECHANISMS, GENETICS, AND FRAILTY | 1137 | ||
| PHARMACOTHERAPY IN THE FRAIL ELDERLY | 1137 | ||
| INTERVENTIONS TO PREVENT AND TREAT FRAILTY AND ITS SEQUELAE | 1139 | ||
| REFERENCES | 1140 | ||
| CHAPTER 206: Caregiver Burden | 1140 | ||
| PALLIATIVE CARE STAFF: THE CHRONIC BURDEN | 1140 | ||
| FAMILY CAREGIVERS: THE ACUTE BURDEN | 1140 | ||
| THE CONCEPT OF VULNERABILITY | 1141 | ||
| MEASUREMENT OF CAREGIVER BURDEN | 1141 | ||
| TREATMENT OF CAREGIVER BURDEN | 1142 | ||
| WORKPLACE STRESS MANAGEMENT FOR PALLIATIVE CARE WORKERS | 1142 | ||
| INTERVENTION TO FACILITATE FAMILY CAREGIVING | 1142 | ||
| REFERENCES | 1142 | ||
| CHAPTER 207: Community Services | 1143 | ||
| CASE MANAGEMENT | 1143 | ||
| RESPITE SERVICES | 1143 | ||
| HOME CARE SERVICES | 1144 | ||
| COMMUNITY PALLIATIVE CARE SERVICES | 1144 | ||
| PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY | 1144 | ||
| HOSPICE CARE IN NURSING HOMES | 1145 | ||
| SPIRITUAL RESOURCES | 1146 | ||
| COMMUNITY RESOURCE LINKS | 1146 | ||
| REFERENCES | 1146 | ||
| SECTION E: Acquired Immunodeficiency Syndrome | 1147 | ||
| CHAPTER 208: Acquired Immunodeficiency Syndrome: A Global Perspective | 1147 | ||
| BASIC SCIENCE | 1147 | ||
| EPIDEMIOLOGY | 1147 | ||
| PREVALENCE | 1150 | ||
| TREATMENT AND PREVENTION | 1151 | ||
| REFERENCES | 1151 | ||
| CHAPTER 209: Biology and Natural History of Acquired Immunodeficiency Syndrome | 1151 | ||
| BASIC SCIENCE | 1152 | ||
| PATHOGENESIS | 1153 | ||
| CLINICAL MANIFESTATIONS | 1154 | ||
| TREATMENT | 1156 | ||
| REFERENCES | 1156 | ||
| CHAPTER 210: Acquired Immunodeficiency Syndrome in Adults | 1157 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1157 | ||
| PATHOPHYSIOLOGY | 1157 | ||
| DIAGNOSIS | 1159 | ||
| EVALUATION | 1159 | ||
| CLINICAL MANIFESTATIONS | 1160 | ||
| COINFECTION | 1160 | ||
| TREATMENT | 1161 | ||
| PREVENTION | 1163 | ||
| REFERENCES | 1163 | ||
| SUGGESTED READING | 1163 | ||
| CHAPTER 211: Palliative Care for Children and Adolescents with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome | 1163 | ||
| DEFINITION OF PALLIATIVE CARE FOR CHILDREN | 1164 | ||
| HIV INFECTION IN CHILDREN | 1165 | ||
| DIAGNOSIS | 1165 | ||
| PATHOPHYSIOLOGY | 1165 | ||
| CLINICAL MANIFESTATIONS | 1165 | ||
| TREATMENT | 1165 | ||
| SYMPTOM MANAGEMENT | 1167 | ||
| END-OF-LIFE CARE | 1171 | ||
| ORPHANS AND VULNERABLE CHILDREN | 1172 | ||
| REFERENCES | 1172 | ||
| SUGGESTED READING | 1172 | ||
| CHAPTER 212: Complications of Acquired Immunodeficiency Syndrome | 1172 | ||
| BASIC SCIENCE | 1173 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1174 | ||
| PATHOPHYSIOLOGY | 1174 | ||
| CLINICAL MANIFESTATIONS | 1177 | ||
| TREATMENT | 1179 | ||
| CONCLUSIONS | 1181 | ||
| REFERENCES | 1182 | ||
| CHAPTER 213: Treatment of Persons Infected with the Human Immunodeficiency Virus | 1183 | ||
| PRINCIPLES OF THERAPY | 1183 | ||
| WHEN TO START ANTIRETROVIRAL THERAPY | 1183 | ||
| CLASSES OF ANTIRETROVIRAL DRUGS | 1184 | ||
| INITIAL THERAPY | 1188 | ||
| INITIATION OF THERAPY IN ADVANCED DISEASE | 1188 | ||
| RESISTANCE TO ANTIRETROVIRAL AGENTS | 1188 | ||
| TOXICITIES OF ANTIRETROVIRAL THERAPY | 1189 | ||
| LONG-TERM COMPLICATIONS OF THERAPY | 1190 | ||
| FUTURE OF ANTIRETROVIRAL THERAPY | 1190 | ||
| REFERENCES | 1190 | ||
| CHAPTER 214: Symptom Management | 1191 | ||
| PAIN MANAGEMENT | 1191 | ||
| SYMPTOM MANAGEMENT | 1193 | ||
| END-STAGE LIVER DISEASE | 1196 | ||
| REFERENCES | 1198 | ||
| SYMPTOM PREVALENCE IN AFRICA | 1199 | ||
| PAIN CONTROL | 1199 | ||
| TRADITIONAL TREATMENTS | 1199 | ||
| COSTS OF PALLIATIVE CARE PROVISION | 1200 | ||
| DRUG INTERACTIONS WITH ANTIRETROVIRAL REGIMENS | 1200 | ||
| CONCLUSIONS | 1200 | ||
| REFERENCES | 1201 | ||
| PART V: Palliative Medicine in Cancer | 1203 | ||
| SECTION A: Cancer | 1204 | ||
| CHAPTER 215: Biology of Cancer | 1204 | ||
| PRINCIPLES OF TUMOR INVASION AND METASTASIS | 1204 | ||
| RESEARCH CHALLENGES AND CONCLUSIONS | 1206 | ||
| REFERENCES | 1207 | ||
| SUGGESTED READING | 1207 | ||
| CHAPTER 216: Epidemiology of Cancer | 1207 | ||
| INCIDENCE | 1207 | ||
| MORTALITY | 1209 | ||
| PREVALENCE | 1211 | ||
| SURVIVAL | 1212 | ||
| DEVELOPMENTS AND CONTROVERSIES IN PALLIATIVE CARE | 1212 | ||
| REFERENCES | 1213 | ||
| SUGGESTED READING | 1213 | ||
| CHAPTER 217: Natural History of Cancer | 1214 | ||
| CARCINOGENESIS | 1214 | ||
| REGULATION OF NORMAL AND TUMOR CELL GROWTH | 1217 | ||
| DEVELOPMENTS IN TREATMENT | 1220 | ||
| CONCLUSIONS | 1221 | ||
| BIBLIOGRAPHY | 1222 | ||
| CHAPTER 218: Principles of Medical Oncology | 1223 | ||
| BIOLOGICAL BASIS FOR CANCER TREATMENT | 1223 | ||
| GENERAL PRINCIPLES OF MEDICAL ONCOLOGY | 1224 | ||
| TREATMENT | 1227 | ||
| ONCOLOGY AND PALLIATIVE CARE | 1229 | ||
| CONCLUSIONS | 1230 | ||
| REFERENCES | 1230 | ||
| SUGGESTED READING | 1230 | ||
| SECTION B: Complications | 1231 | ||
| CHAPTER 219: Patterns of Metastatic Cancer | 1231 | ||
| BASIC SCIENCE | 1231 | ||
| COMMON SITES OF METASTATIC SPREAD | 1232 | ||
| REFERENCES | 1236 | ||
| CHAPTER 220: Neurological Complications | 1237 | ||
| BRAIN METASTASES | 1237 | ||
| LEPTOMENINGEAL METASTASES | 1237 | ||
| METASTATIC SPINAL CORD COMPRESSION | 1238 | ||
| NEOPLASIA- AND RADIATION-INDUCED PLEXOPATHIES | 1238 | ||
| CEREBROVASCULAR COMPLICATIONS OF CANCER | 1238 | ||
| PARANEOPLASTIC SYNDROMES | 1239 | ||
| NEUROTOXICITY OF CANCER CHEMOTHERAPY | 1239 | ||
| CURRENT CONTROVERSIES AND FUTURE CONSIDERATIONS | 1239 | ||
| REFERENCES | 1240 | ||
| SUGGESTED READING | 1240 | ||
| CHAPTER 221: Brain Metastases | 1240 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1241 | ||
| PATHOPHYSIOLOGY | 1241 | ||
| CLINICAL MANIFESTATIONS | 1242 | ||
| DIFFERENTIAL DIAGNOSIS | 1242 | ||
| MANAGEMENT | 1243 | ||
| REFERENCES | 1244 | ||
| CHAPTER 222: Bone Metastases | 1244 | ||
| PATHOPHYSIOLOGY | 1245 | ||
| CLINICAL MANIFESTATIONS | 1245 | ||
| TREATMENT | 1246 | ||
| REFERENCES | 1247 | ||
| CHAPTER 223: Vertebral Metastases and Spinal Cord Compression | 1247 | ||
| VERTEBRAL METASTASES | 1247 | ||
| SPINAL CORD COMPRESSION | 1251 | ||
| SUMMARY | 1258 | ||
| REFERENCES | 1259 | ||
| CHAPTER 224: Malignant Ascites | 1260 | ||
| PREVALENCE AND ETIOLOGY | 1261 | ||
| CLINICAL SYMPTOMS AND DIAGNOSIS | 1261 | ||
| PATHOGENESIS | 1261 | ||
| PROGNOSIS | 1261 | ||
| MANAGEMENT AND TREATMENT | 1261 | ||
| REFERENCES | 1263 | ||
| CHAPTER 225: Pleural and Pericardial Effusions | 1263 | ||
| BASIC SCIENCE | 1263 | ||
| EPIDEMIOLOGY | 1264 | ||
| CLINICAL MANIFESTATIONS | 1264 | ||
| DIFFERENTIAL DIAGNOSIS | 1264 | ||
| TREATMENT | 1265 | ||
| SUMMARY | 1267 | ||
| REFERENCES | 1267 | ||
| CHAPTER 226: Intestinal Dysfunction and Obstruction | 1267 | ||
| UPPER GASTROINTESTINAL DYSFUNCTION | 1267 | ||
| MALIGNANT INTESTINAL OBSTRUCTION | 1269 | ||
| REFERENCES | 1275 | ||
| CHAPTER 227: Genitourinary Complications in Palliative Oncology | 1276 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1276 | ||
| CLINICAL MANIFESTATIONS | 1276 | ||
| DIFFERENTIAL DIAGNOSIS | 1277 | ||
| TREATMENT | 1278 | ||
| REFERENCES | 1281 | ||
| SUGGESTED READING | 1281 | ||
| SECTION C: Cancer-Related Syndromes | 1282 | ||
| CHAPTER 228: Hypercalcemia | 1282 | ||
| BASIC SCIENCE | 1282 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1282 | ||
| PATHOPHYSIOLOGY | 1282 | ||
| CLINICAL MANIFESTATIONS | 1283 | ||
| DIFFERENTIAL DIAGNOSIS | 1283 | ||
| TREATMENT | 1284 | ||
| REFERENCES | 1285 | ||
| CHAPTER 229: Bone Marrow Failure | 1286 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1286 | ||
| PATHOPHYSIOLOGY | 1286 | ||
| CLINICAL MANIFESTATIONS | 1287 | ||
| INVESTIGATIONS | 1287 | ||
| TREATMENT | 1289 | ||
| REFERENCES | 1292 | ||
| CHAPTER 230: Bleeding and Clotting Disorders in Cancer | 1293 | ||
| EPIDEMIOLOGY AND RISK FACTORS | 1293 | ||
| PATHOPHYSIOLOGY | 1295 | ||
| BASIC SCIENCE | 1297 | ||
| CLINICAL DIAGNOSIS | 1297 | ||
| DIFFERENTIAL DIAGNOSIS | 1301 | ||
| MANAGEMENT | 1301 | ||
| CONCLUSIONS | 1304 | ||
| REFERENCES | 1304 | ||
| SUGGESTED READING | 1305 | ||
| CHAPTER 231: The Vena Cava Syndrome | 1305 | ||
| SUPERIOR VENA CAVA SYNDROME | 1305 | ||
| INFERIOR VENA CAVA SYNDROME | 1307 | ||
| SUGGESTED READING | 1307 | ||
| CHAPTER 232: Oral Complications of Cancer and Its Treatment | 1307 | ||
| CLINICAL EVALUATION | 1307 | ||
| ORAL MUCOSITIS | 1308 | ||
| OSTEORADIONECROSIS | 1309 | ||
| SALIVARY GLAND HYPOFUNCTION | 1309 | ||
| TASTE ALTERATION | 1310 | ||
| PERIODONTAL DISEASE | 1310 | ||
| INFECTIONS | 1310 | ||
| CONCLUSIONS | 1311 | ||
| REFERENCES | 1311 | ||
| CHAPTER 233: Paraneoplastic Syndromes | 1311 | ||
| PATHOGENETIC MECHANISMS | 1311 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1314 | ||
| PATHOPHYSIOLOGY | 1314 | ||
| CLINICAL MANIFESTATIONS | 1315 | ||
| DIFFERENTIAL DIAGNOSIS | 1317 | ||
| TREATMENT | 1317 | ||
| REFERENCES | 1319 | ||
| SUGGESTED READING | 1319 | ||
| CHAPTER 234: Autonomic Dysfunction | 1319 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1320 | ||
| PATHOPHYSIOLOGY | 1321 | ||
| CLINICAL MANIFESTATIONS | 1321 | ||
| DIFFERENTIAL DIAGNOSIS | 1322 | ||
| TREATMENT | 1323 | ||
| SUMMARY | 1323 | ||
| REFERENCES | 1323 | ||
| SUGGESTED READING | 1323 | ||
| SECTION D: Antitumor Therapy | 1324 | ||
| CHAPTER 235: Radiation Principles and Techniques | 1324 | ||
| IONIZING RADIATION, EXTERNAL BEAM RADIATION (TELETHERAPY), AND BRACHYTHERAPY | 1324 | ||
| SIMULATION AND TREATMENT PLANNING | 1325 | ||
| INTENSITY-MODULATED RADIATION THERAPY | 1325 | ||
| STEREOTACTIC RADIOSURGERY | 1326 | ||
| BIOLOGICAL PRINCIPLES | 1326 | ||
| RADIOSENSITIZERS | 1327 | ||
| REFERENCES | 1327 | ||
| CHAPTER 236: Complications of Radiation Therapy | 1327 | ||
| BASIC SCIENCE AND RADIOBIOLOGY | 1327 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1327 | ||
| GENETICS OF RADIOSENSITIVITY | 1328 | ||
| PATHOPHYSIOLOGY | 1328 | ||
| HISTOPATHOLOGY | 1329 | ||
| CLINICAL MANIFESTATIONS | 1329 | ||
| PREVENTIVE STRATEGIES | 1329 | ||
| MANAGEMENT OF ACUTE TOXICITY | 1330 | ||
| MANAGEMENT OF LATE TOXICITY | 1332 | ||
| REFERENCES | 1336 | ||
| CHAPTER 237: Palliative Radiation Therapy | 1337 | ||
| PRINCIPLES OF PALLIATIVE RADIATION THERAPY | 1337 | ||
| BONE METASTASES—TRIAL RESULTS | 1338 | ||
| SPINAL CORD COMPRESSION—TRIAL RESULTS | 1339 | ||
| ADVANCED LUNG CANCER—TRIAL RESULTS | 1341 | ||
| COST-EFFECTIVENESS | 1342 | ||
| INTEGRATION OF PALLIATIVE RADIOTHERAPY WITH OTHER MODALITIES | 1343 | ||
| RECENT DEVELOPMENTS | 1343 | ||
| EVIDENCE-BASED MEDICINE | 1344 | ||
| RESEARCH CHALLENGES | 1344 | ||
| CONCLUSION | 1344 | ||
| REFERENCES | 1344 | ||
| SUGGESTED READING | 1345 | ||
| CHAPTER 238: Principles of Modern Chemotherapy and Endocrine Therapy | 1345 | ||
| TREATMENT INTENT | 1345 | ||
| CHEMOTHERAPY | 1345 | ||
| BIOLOGICAL AND TARGETED THERAPY | 1349 | ||
| IMMUNOTHERAPY | 1349 | ||
| ENDOCRINE THERAPY | 1351 | ||
| STOPPING PALLIATIVE ANTICANCER TREATMENT | 1351 | ||
| CONCLUSIONS | 1352 | ||
| REFERENCES | 1352 | ||
| SUGGESTED READING | 1352 | ||
| CHAPTER 239: Complications of Chemotherapy | 1353 | ||
| ALOPECIA | 1353 | ||
| GASTROINTESTINAL COMPLICATIONS | 1353 | ||
| HEMATOLOGICAL COMPLICATIONS | 1355 | ||
| PULMONARY TOXICITY | 1357 | ||
| CARDIOTOXICITY | 1357 | ||
| NEPHROTOXICITY | 1357 | ||
| NEUROTOXICITY | 1358 | ||
| EXTRAVASATION | 1358 | ||
| REFERENCES | 1359 | ||
| SUGGESTED READING | 1360 | ||
| CHAPTER 240: Palliative Chemotherapy and Corticosteroids | 1360 | ||
| RECENT DEVELOPMENTS | 1360 | ||
| EVIDENCE-BASED MEDICINE | 1361 | ||
| CONCLUSIONS | 1362 | ||
| PALLIATIVE CHEMOTHERAPY CONCLUSIONS | 1362 | ||
| REFERENCES | 1363 | ||
| CHAPTER 241: Principles and Practice of Surgical Oncology | 1363 | ||
| DIAGNOSIS AND STAGING | 1363 | ||
| CURATIVE SURGERY | 1364 | ||
| PALLIATIVE SURGERY | 1365 | ||
| SURGERY FOR METASTASES | 1365 | ||
| CANCER PREVENTION SURGERY | 1366 | ||
| FOLLOW-UP AFTER SURGERY | 1366 | ||
| REFERENCES | 1366 | ||
| CHAPTER 242: Palliative Orthopedic Surgery | 1367 | ||
| IMPENDING AND PATHOLOGICAL FRACTURES | 1367 | ||
| SPINAL INSTABILITY | 1369 | ||
| SPINAL CORD COMPRESSION | 1371 | ||
| ADVANCES | 1371 | ||
| REFERENCES | 1372 | ||
| CHAPTER 243: Modern Supportive Care in Oncology | 1373 | ||
| RECENT DEVELOPMENTS | 1373 | ||
| EVIDENCE-BASED MEDICINE | 1376 | ||
| RESEARCH CHALLENGES | 1376 | ||
| CONCLUSIONS | 1377 | ||
| REFERENCES | 1377 | ||
| SUGGESTED READING | 1377 | ||
| SECTION E: Cancer Pain | 1378 | ||
| CHAPTER 244: Pathophysiology of Cancer Pain | 1378 | ||
| NORMAL PAIN TRANSMISSION | 1378 | ||
| RECENT DEVELOPMENTS | 1380 | ||
| RESEARCH CHALLENGES AND ADVANCES | 1383 | ||
| CONCLUSIONS | 1384 | ||
| REFERENCES | 1384 | ||
| SUGGESTED READING | 1384 | ||
| CHAPTER 245: Psychological and Psychiatric Approaches | 1384 | ||
| THEORY | 1385 | ||
| INTERVENTIONS | 1386 | ||
| RECENT DEVELOPMENTS | 1388 | ||
| EVIDENCE-BASED MEDICINE | 1388 | ||
| RESEARCH CHALLENGES/OPPORTUNITIES | 1388 | ||
| CONCLUSIONS | 1388 | ||
| REFERENCES | 1388 | ||
| SUGGESTED READING | 1388 | ||
| CHAPTER 246: Rehabilitation Approaches | 1389 | ||
| REHABILITATION—A NEW PARADIGM FOR PALLIATIVE CARE? | 1389 | ||
| ROLE OF MEDICAL AND NURSING PRACTITIONERS AND THE WIDER TEAM IN PALLIATIVE CARE REHABILITATION | 1390 | ||
| TEAMWORK, THE REHABILITATION TEAM, AND GOAL SETTING | 1392 | ||
| RECENT DEVELOPMENTS | 1392 | ||
| EVIDENCE-BASED MEDICINE | 1392 | ||
| CONTROVERSIES | 1393 | ||
| CONCLUSIONS | 1393 | ||
| ACKNOWLEDGEMENT | 1393 | ||
| REFERENCES | 1393 | ||
| SUGGESTED READING | 1394 | ||
| CHAPTER 247: Cancer Pain: Anesthetic and Neurosurgical Interventions | 1394 | ||
| CLINICAL FINDINGS AND EVALUATION | 1394 | ||
| ANESTHETIC/ANALGESIC INTERVENTIONS | 1395 | ||
| RECENT DEVELOPMENTS | 1397 | ||
| EVIDENCE-BASED MEDICINE | 1397 | ||
| CONTROVERSIES | 1397 | ||
| RESEARCH CHALLENGES/OPPORTUNITIES/ADVANCES | 1398 | ||
| REFERENCES | 1398 | ||
| SUGGESTED READING | 1398 | ||
| CHAPTER 248: Acupuncture, Transcutaneous Electrical Nerve Stimulation, and Topical Analgesics | 1398 | ||
| ACUPUNCTURE | 1399 | ||
| TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION | 1401 | ||
| TOPICAL ANALGESICS | 1402 | ||
| EVIDENCE-BASED MEDICINE | 1402 | ||
| CONCLUSIONS | 1403 | ||
| REFERENCES | 1403 | ||
| SUGGESTED READING | 1404 | ||
| CHAPTER 249: Opioids for Cancer Pain | 1404 | ||
| RECENT DEVELOPMENTS | 1404 | ||
| REFERENCES | 1411 | ||
| SUGGESTED READING | 1411 | ||
| CHAPTER 250: Opioid Side Effects and Overdose | 1411 | ||
| UNDERLYING CONSIDERATIONS | 1412 | ||
| SPECIFIC SIDE EFFECTS | 1413 | ||
| OPIOID OVERDOSE | 1415 | ||
| CONCLUSIONS | 1415 | ||
| REFERENCES | 1416 | ||
| CHAPTER 251: Opioid Use in Drug and Alcohol Abuse | 1416 | ||
| EPIDEMIOLOGY | 1417 | ||
| CLINICAL MANAGEMENT | 1417 | ||
| CONCLUSIONS | 1420 | ||
| REFERENCES | 1420 | ||
| CHAPTER 252: Nonopioid and Adjuvant Analgesics | 1421 | ||
| PHARMACOLOGY OF ANTIDEPRESSANTS AND ANTICONVULSANTS | 1421 | ||
| EVIDENCE-BASED MEDICINE | 1421 | ||
| RESEARCH CHALLENGES, OPPORTUNITIES, AND ADVANCES | 1424 | ||
| CONCLUSIONS | 1424 | ||
| REFERENCES | 1424 | ||
| CHAPTER 253: Challenging Pain Problems | 1425 | ||
| DEFINITION OF DIFFICULT PAIN PROBLEMS | 1425 | ||
| INCIDENT PAIN | 1425 | ||
| NEUROPATHIC PAIN | 1427 | ||
| ANESTHETIC TECHNIQUES FOR DIFFICULT PAIN | 1429 | ||
| CONCLUSIONS | 1430 | ||
| REFERENCES | 1430 | ||
| CHAPTER 254: Pain in Cancer Survivors | 1430 | ||
| EPIDEMIOLOGY AND PREVALENCE | 1431 | ||
| PATHOPHYSIOLOGY | 1431 | ||
| CLINICAL MANIFESTATIONS | 1432 | ||
| DIFFERENTIAL DIAGNOSIS | 1433 | ||
| TREATMENT | 1433 | ||
| REFERENCES | 1435 | ||
| SUGGESTED READING | 1435 | ||
| INDEX | 1437 |