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Biomedical subjects

C A Jenkins

Publications and source records attributed to C A Jenkins.

12 recordsLinked to original sources
PubMed2000

Difficulties in diagnosing neuropsychiatric complications of corticosteroids in advanced cancer patients: two case reports.

Because of their variety of uses, corticosteroids are frequently prescribed in advanced cancer patients. Two patients who developed neuropsychiatric complications on corticosteroids and their subsequent management are described. The first patient, who had a known history of steroid-induced psychotic depression, required corticosteroids to treat recurrent brain edema from a malignant meningioma. The patient was managed by using low-dose corticosteroids and concomitant haloperidol. The second patient was prescribed corticosteroids for a constellation of symptoms, including pain and nausea from a possible bowel obstruction, and developed a severe delirium that required discontinuation of the corticosteroids. The difficulties of diagnosing steroid-related cognitive and mood changes in advanced cancer patients who often have multisystem disease are discussed, as well as strategies for minimizing the effects of corticosteroids' neuropsychological complications.

Adrenal Cortex Hormones↗
PubMed2000

Demographic, symptom, and medication profiles of cancer patients seen by a palliative care consult team in a tertiary referral hospital.

In this retrospective study, the charts of 100 consecutive cancer patients who had been referred to a palliative care consult team within a tertiary acute care hospital were reviewed. Demographic characteristics, including reason for admission and disease status upon admission, length of stay, and discharge and admission location, were recorded. Symptom acuity, cognitive status, and risk for substance abuse were evaluated. Medications before and after the consult were tabulated and compared to recommended medications; compliance with the recommendations was assessed. Five patients were not palliative at the time of the consult. Only 46/95 (48%) were known to have untreatable cancer at the time of their admission. The CAGE questionnaire for alcoholism and the Mini-Mental State Questionnaire (MMSQ) were abnormal in 19/78 (24%) and 40/91 (44%), respectively. The most intense symptoms, as measured by the 100-mm scales of the Edmonton Symptom Assessment Scale (ESAS) were fatigue (72 +/- 24), appetite (60 +/- 32), and well-being (50 +/- 29). Eighty-nine of the 95 patients were living at home prior to admission and 34/95 were able to return home. Twenty died during hospitalization, 23 were transferred to a palliative care unit, and the remaining 18 were discharged to another hospital or long-term care. The patient's physician complied with the palliative care consult team's recommendation in 122/137 cases (89%).

Adult↗
PubMed1999

Nonsteroidal anti-inflammatory drugs as adjuvant analgesics in cancer patients.

The role of nonsteroidal anti-inflammatory drugs (NSAIDs) is examined in the control of cancer pain with a particular focus on their use as adjuvants to opioids in advanced cancer pain. These agents have both a peripheral effect on inflammation and a role in attenuating central pain pathways. The possibility of obtaining the benefits of NSAIDs with fewer side-effects by using COX-2-specific agents is discussed. The gastrointestinal, renal, haemostatic, cognitive and hypersensitivity side-effects of NSAIDs are reviewed and their potential impact assessed. The evidence for the efficacy of NSAIDs as single agents for cancer pain is reviewed together with the nine papers which have reported the effects of NSAIDs as adjuvants to opioids in cancer pain. All of these papers reported positive results of NSAIDs, but, in the absence of any randomized, double-blind controlled trials, where NSAIDs were used as adjuvants on a long-term basis alongside optimal opioid use, definite conclusions cannot be reached. Guidelines for the safe use of NSAIDs are suggested. Finally, suggestions for future research are made.

Analgesics↗
PubMed1998

Initial demographic, symptom, and medication profiles in patients admitted to continuing palliative care units.

We retrospectively reviewed 110 consecutive admissions to continuing palliative care units, which were designed as part of a regionalized, comprehensive palliative care program in Edmonton, Canada. Ninety-six patient charts met the criteria for evaluation. Demographic characteristics, and, when available, symptom profiles, cognitive status, and risk for a history of substance abuse were described. The medications on admission were tabulated, and in those 93 patients who had consults done by a palliative care consultant, these are compared to recommended medications. This study showed an older cohort of patient (mean +/- SD = 75 +/- 11 years) than had previously been described in a tertiary unit in the same community. Median length of stay was 21 days (range, 0-> 200 days). Cognitive impairment was higher than would be anticipated on the basis of age alone, with 32/47 [64% (confidence interval (CI) 55%-81%)] of patients who had had cognitive testing done on the day of consult being found to be cognitively impaired. Symptoms, as measured by the Edmonton Symptom Assessment Scale, were similar to those found for patients admitted to the tertiary palliative care unit. In the 93 patients who had palliative care consults done on admission, there were a total of 179 recommendations for medication or hydration changes. Overall compliance with these recommendations was 84% (CI, 79%-89%). The highest compliance was observed for recommendations to start hydration clysis [27/27, 100% (CI, 100%)], and the lowest rate was observed for altering or decreasing hypnotic medications [11/22, 50% (CI, 29%-71%)]. We conclude that the patients were of higher acuity than anticipated.

Adult↗
PubMed1998

Integration of palliative care with alternative medicine in patients who have refused curative cancer therapy: a report of two cases.

This article describes two young, potentially curable patients who chose a course of treatment that ultimately resulted in death. Their choice was in part influenced by the prospect of the disfiguring surgery that would have been required for cure. In the first patient this would have meant massive head and neck surgery, in the second, a radical hysterectomy that would have resulted in surgical menopause. The availability of practitioners who promised an easier cure was also a factor in swaying the first patient away from truly curative therapy. Denial also played a role in both of these patients' decisions. Part of their denial may have been exacerbated by the fact that both of their cancers have as risk factors behaviors that the patients may have considered inconsistent with their value system. In the first type of cancer, alcohol and chewing tobacco are major risk factors (11), neither of which would have been acceptable to the patient's family. In the second type, multiple sexual partners are a major risk for cervical cancer (12), a behavior which is inconsistent with the teachings of the patient's fundamentalist Christian beliefs. The approach that we have described--expressions of respect for the patient's belief system combined with the nonconfrontational offering of treatments with immediate symptomatic benefit--resulted in the development of an effective working relationship between patient, family, and palliative care team.

Adult↗
PubMed1994

Effects of a common linguistic misrepresentation on judgments about the relationship between height and weight.

Researchers have debated whether laypeople can detect covariation and have tried to identify conditions that might facilitate or retard this ability. Language, especially linguistic representation of variables, seems important to consider since misrepresentation appears to be relatively common in linguistic exchanges. In the present theory-based experiment, 16 subjects were asked to make judgments about the relationship between height and either weight (heavy or light) or bodyfat (fat or thin). Data provided evidence of a powerful illusory association, that is, if tall, then thin; if short, then fat, and there was no compelling evidence to suggest that subjects understood the relationship between height and weight.

Body Height↗