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Noel R. Fajardo Filippo Cremonini Dr Nicholas J. Talley 《American Journal of Cancer》2006,5(5):319-330
In patients with cancer, constipation is a common complication. However, unlike in the general population, the impact of the symptoms of constipation on the quality of life in cancer patients is often greater. More importantly, in patients who are in the more advanced stages of the disease, constipation may also be suggestive of disease progression. Constipation as a symptom in this population is of significant importance as it may lead to life-threatening complications, i.e. bowel perforation due to fecal impaction. Therefore, in this regard, this problem deserves particular attention, as early recognition and management of complications may prevent further physical deterioration. This review aims to provide an overview of the management of constipation in patients with cancer. A symptom-based criteria definition for chronic constipation and prevalence of the problem in cancer patients provides a brief introduction. For the initial assessment and evaluation of constipation in cancer patients, an algorithm is described. The different possible etiologies of constipation in cancer patients are also discussed. Regarding therapeutic management, guidelines and recommendations for the use of different types of laxatives, stool softeners, suppositories and rectal enemas, prokinetic agents, antidepressant medications, and miscellaneous agents are succinctly discussed. Management of fecal impaction and opioid-induced bowel dysfunction are also described. Lastly, a brief overview of the management of acute colonic pseudo-obstruction and surgical or endoscopic options for large bowel obstruction are described. 相似文献
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Spencer Moore Cynthia Smith Tammy Simpson Sharlene Wolbeck Minke 《BMC health services research》2006,6(1):141
Background
Knowledge of the structure and character of inter-organizational relationships found among health promotion organizations is a prerequisite for the development of evidence-based network-level intervention activities. The Alberta Healthy Living Network (AHLN) mapped the inter-organizational structure of its members to examine the effects of the network environment on organizational-level perceptions. This exploratory analysis examines whether network structure, specifically partnership ties among AHLN members, influences organizational perceptions of support after controlling for organizational-level attributes. 相似文献106.
Nicholas Kipshidze Martin B Leon 《Journal of the American College of Cardiology》2006,47(9):1911; author reply 1912-1911; author reply 1913
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Seeing the Light: Protein Theories of General Anesthesia 总被引:1,自引:0,他引:1
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Predictors, costs and characteristics of out of area placement for people with intellectual disability and challenging behaviour 总被引:1,自引:0,他引:1
D. G. Allen K. Lowe K. Moore & S. Brophy 《Journal of intellectual disability research : JIDR》2007,51(6):409-416
Background Out of area placements for people with challenging behaviour represent an expensive and often ineffective strategy for meeting the needs of this service user group. Methods More than 800 agencies and service settings in a large area of South Wales were screened to identify children and adults with challenging behaviour against a number of defined operational criteria. Detailed data on identified individuals and the services they received were collected by interviewing key informants. Univariate and multivariate statistics were employed to identify predictors of out of area placement. Results In total, 1458 people were identified. Full data were available for 901 participants, 97 of whom were placed out of area. Predictors of out of area placement included behaviours resulting in physical injury and exclusion from service settings, a history of formal detention under the mental health act, the presence of mental health problems, a diagnosis of autism and higher total score on the Adaptive Behaviour Scale. Out of area placements were typically of high cost, and associated with only limited evidence of improved service quality. Conclusions Identifying predictors for out of area placement can be used to highlight deficiencies in local services and individuals at increased risk of exclusion from local services. 相似文献
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