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Biomedical subjects

V Ventafridda

Publications and source records attributed to V Ventafridda.

At least 37 records · Page 2Linked to original sources
PubMed1993

Management of bowel obstruction in advanced and terminal cancer patients.

BACKGROUND: Bowel obstruction is a common and distressing outcome in patients with abdominal or pelvic cancer. PATIENTS AND METHOD: Patients may develop bowel obstruction at any time in their clinical history, with an incidence ranging from 5.5% to 42% in ovarian carcinoma and from 10% to 28.4% in colorectal cancer. The causes of the obstruction may be benign postoperative adhesions, a focal malignant or benign deposit, relapse or diffuse carcinomatosis. The symptoms which are almost always present are intestinal colic (reported in 72%-76% of patients), abdominal pain due to distension, hepatomegaly or tumor masses (in 92% of patients) and vomiting (68%-100%) of cases. CONCLUSION: While surgery must remain the primary treatment for malignant obstruction, it is now recognised that there is a group of patients with advanced disease or poor general condition who are unfit for surgery and require alternative management to relieve distressing symptoms. A number of treatment options are now available for the patient with advanced cancer who develops intestinal obstruction. In this review of the literature, the indications for surgery will be examined, the use of nasogastric tube and percutaneous gastrostomy evaluated and the place of drugs for symptom control described.

Abdominal Neoplasms↗
PubMed1993

Psychological aspects of genital human papillomavirus infection: a preliminary report.

Genital human papillomavirus (HPV) infection can lead to self-inflicted blame and hypochondriac fears as well as to problems with sexuality. The aim of this study was to assess the psychological and psychodynamic aspects of patients with widespread genital HPV infection entering into a clinical trial in which they were randomly assigned to three treatment groups: CO2 laser ablation, intramuscular interferon-alpha, CO2 laser ablation plus intramuscular interferon-alpha. Fifty-one patients were studied. Patients were asked to take a series of questionnaires which included a self-rating questionnaire for gathering information on sexuality, emotional relationship with the partner and social life. A visual analog scale was used to rate intensity of pain during sexual intercourse. Each patient went also through an in-depth interview with a clinical psychologist and filled out two personality tests to measure depression (CDQ = IPAT depression test) and anxiety (ASQ = IPAT anxiety test). Results indicated a high percentage of sexual impairments after therapy (28 cases), presence of fear of cancer (14 cases) and worsenings in the emotional relationship with the partner. No difference was found among groups of treatment.

Adult↗
PubMed1992

A therapy impact questionnaire for quality-of-life assessment in advanced cancer research.

The first part of the validation procedure used for a Therapy Impact Questionnaire (TIQ) on quality-of-life assessment in advanced cancer patients is described. The TIQ is composed of 36 items which assess both disease and therapy impact according to four dimensions that operationally define quality of life: physical symptoms (24 items), functional status (3 items), concomitant emotional and cognitive factors (6 items) and social interaction (2 items). A global judgement expressed as "have you been feeling ill" further completes the TIQ. Patients answered each question using a 4-point verbal Likert scale: not at all, slight, a lot and very much. The TIQ was given to 1,000 consecutive patients who were no longer responsive to cancer treatment and presented symptoms due to disease progression. The compliance rate was quite high (87%). Results of confirmatory factor analysis were consistent with the operational dimensions identified during questionnaire construction. In particular, the dichotomized answers to 3 functional status items could be used as a Guttman scale. In a sub-sample of 50 patients, the reproducibility of functional status items was assessed using a 7-item parallel form. The intraclass correlation coefficient obtained indicated a reasonably high reproducibility. On the basis of the analyses conducted, the TIQ appears to be a reliable and concise instrument for studies aimed to assess the effectiveness of therapies in advanced cancer patients.

Adolescent↗
PubMed1991

On the significance of Lhermitte's sign in oncology.

We present three cases of Lhermitte's sign out of twenty consecutive cases of epidural spinal cord compression due to metastatic cancer. The three patients were diagnosed with epidural thoracic compressions. The literature on Lhermitte's sign is reviewed with emphasis on the differential diagnosis of this symptom in oncological patients.

Adult↗
PubMed1991

Local toxicity with subcutaneous methadone. Experience of two centers.

We report on 8 patients treated with subcutaneous methadone for cancer-related pain at 2 institutions. The success of other subcutaneous agents for pain control has been well demonstrated. It was felt that methadone would be useful due to its low cost. Unfortunately, 7 of the 8 patients experienced adverse reactions at the subcutaneous sites requiring cessation of subcutaneous methadone.

Adult↗
PubMed1991

Continuous subcutaneous infusion of hyoscine butylbromide reduces secretions in patients with gastrointestinal obstruction.

We describe the use of hyoscine butylbromide as a subcutaneous infusion in 3 patients with inoperable malignant bowel obstruction. An objective reduction of drainage from the gastrointestinal tract was observed with the hyoscine butylbromide infusion (60-120 mg/day). We suggest that this effect can be useful in the palliative treatment of vomiting in inoperable bowel obstruction.

Aged↗
PubMed1991

Skin problems in advanced and terminal cancer patients.

Disturbances caused by skin problems may compromise the quality of life of cancer patients. The main complications affecting the skin comprise the dermatologic toxicity of anticancer therapy, bedsores, malignant ulcers, sores due to nonmetastatic cancer, pruritus, and infections. Most of the information available about these entities has been acquired in the cancer patient without advanced disease. The little currently known about the epidemiology and physiopathology of such lesions in the advanced phase of cancer is presented, and approaches to management are suggested.

Humans↗
PubMed1991

A clinical study on the use of codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine in cancer pain.

The authors report a prospective study on 944 cancer pain patients treated with one of the following opioids: codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine. Level of analgesia, duration of treatment, side effects, and drop out were evaluated for each drug. Twenty-four percent of the patients still benefitted from treatment at the fourth week of study, even if high drug dosages were not used. Pentazocine did not show an evident analgesic effect during the first 2 wk of treatment. The other opioids were found to be valid therapeutic instruments for chronic cancer pain control in a limited number of patients.

Adult↗
PubMed1991

Antidepressants in cancer pain.

Studies conducted in recent years have helped define the role of antidepressant drugs in the management of cancer pain. The antinociceptive action of these agents seems to be independent of beneficial effect on depression or mood. Among antidepressant drugs, those of the tricyclic class are preferred when an analgesic effect is sought. Their primary application is for pain due to nerve injury, so-called "neuropathic pain". Although the co-administration of tricyclic antidepressants may increase plasma morphine concentrations, any potentiation of morphine analgesia is thought not to be due to an increased bioavailability of the opiate, but to an intrinsic analgesic effect of antidepressants. On this basis, the use of antidepressants in combination with opioids for the treatment of cancer pain is suitable when a component of deafferentation is present or when there is concomitant depressive illness.

Antidepressive Agents↗
PubMed1991

Plasma morphine and morphine-6-glucuronide patterns in cancer patients after oral, subcutaneous, sublabial and rectal short-term administration.

Clinical studies on the effectiveness of morphine administered through different routes are contradictory. In order to further elucidate this point, the plasma concentrations of morphine and its 3- and 6-glucuronated metabolites were measured after short-term oral, sublabial, rectal and subcutaneous administration of the opiate. The bioavailability of free morphine and the 6-glucuronated active metabolite was comparable through the different routes. It was concluded that the choice of the route of morphine administration should be mainly guided by the needs of each individual patient.

Aged↗
PubMed1990

The management of inoperable gastrointestinal obstruction in terminal cancer patients.

The aim of the study was to assess vomit and pain control in terminal cancer patients with inoperable gastrointestinal obstruction, using a pharmacologic symptomatic treatment which prevents recourse to nasogastric tube placement and intravenous hydration, in hospital and home care settings. Twenty-two symptomatic patients, who were judged as inoperable, were treated with a pharmacologic association of morphine hydrochloride and scopolamine butylbromide as analgesics and haloperidol as an antiemetic. The drugs were administered by continuous subcutaneous infusion via a syringe driver or intravenously only when a central venous catheter had been inserted previously. Daily recordings included assessment of pain, number of vomiting episodes, dry mouth, drowsiness, and thirst sensation. Data were examined before starting the treatment (T0), 2 days after (T2) and 2 days before death (T-2). They showed that there was a significant decrease in the pain score (p less than 0.001) on T2 and a further decrease on T-2 (p less than 0.05). Vomiting was controlled in all patients, with the exception of three patients with upper abdomen obstruction who required nasogastric tube placement. Dry mouth showed an upward trend throughout the observation period (p less than 0.05) but was successfully treated by administering liquids by mouth or ice-cubes to suck. Drowsiness too presented an upward trend from T0 to T-2 (p less than 0.001). Only one patient out of 16 who reported to be thirsty required intravenous hydration. We believe that in terminal cancer patients, vomit and pain resulting from inoperable intestinal obstruction, with the exception of obstruction of the upper abdomen, can be controlled through administration of analgesic and antiemetic drugs, in the hospital and at home, without recourse to nasogastric tube placement or intravenous hydration.

Abdominal Neoplasms↗
PubMed1990

Quality-of-life assessment during a palliative care programme.

By means of a cross-sectional study, 115 terminal cancer patients (53 males, 62 females) who were no longer responsive to anticancer treatment, were investigated. The sample included all patients who had been undergoing palliative care (PC) during a single week (at the out-patient clinic, in hospital or at home). From the start of PC, the quality of the patients' lives was assessed by a weekly self-descriptive record comprising 32 items at four levels of intensity. The responses given on the questionnaire during the sample week were compared to those given by the same patients at the beginning of PC (T0). From T0 to time during treatment, figures show a significant increase in the percentage of patients who reported drowsiness, and a significant decrease in pain, weakness, functional impairment and psychological distress. The global judgment of not feeling well was reduced from 49% of the patients at TO to 31% during the period of treatment (p less than 0.01). This result shows that, although the disease progressively develops, PC can enhance the quality of the lives of patients during the terminal stages of illness. The subjective judgment of not feeling well was much more closely correlated with physical, functional and psychological symptoms. Of the physical symptoms, pain has the closest correlation with feeling bad. However, pain has a low number of statistically significant correlations with respect to the other items, in marked contrast to the high number of correlations regarding psychological and functional items.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Sectional Studies↗