Subject(s)
Analgesia/methods , Analgesics/administration & dosage , Neoplasms/complications , Oncology Service, Hospital/organization & administration , Pain/drug therapy , Palliative Care/organization & administration , Pharmacy Service, Hospital/organization & administration , Analgesics, Opioid/administration & dosage , Humans , Pain/etiology , Pain Measurement , Palliative Care/methods , Patient Advocacy , Patient Care Team , Sweden , WorkforceSubject(s)
Attitude to Death , Physician's Role , Physician-Patient Relations , Right to Die , Terminal Care , Aged , Female , Humans , Male , Palliative CareSubject(s)
Drug and Narcotic Control , Thymus Extracts/administration & dosage , Drug Approval , Humans , Injections , Naturopathy , SwedenSubject(s)
Death , Euthanasia , Life Support Care , Palliative Care , Terminal Care , Attitude to Death , Euthanasia, Passive , Humans , SwedenSubject(s)
Euthanasia, Passive , Palliative Care , Terminal Care/methods , Female , Humans , Male , SwedenABSTRACT
In 11 patients with long-term indwelling catheters the amount of catheter encrustation and urinary pH were measured and the urine regularly cultured over a prolonged period of time (median of 7 periods of 3 weeks). The mean urinary pH was related to the persistent presence of urease-producing micro-organisms (P. mirabilis) and urinary pH governed the precipitation of catheter encrustation. The critical pH appeared to be around 6.8. In patients with a mean urinary pH below this level the encrustation was minute (less than or equal to 2.9 mg phosphate). In patients with a mean urinary pH above 6.8 it was considerable but with a marked interindividual variation (35.5-138.7 mg phosphate). The composition of the encrustation was also strongly pH-related, with a much higher proportion present as magnesium ammonium phosphate in patients with a mean urinary pH above 6.8. The persistent presence of urease producers was not associated with a high pH or a more pronounced precipitation of phosphate in all patients. The amount of encrustation thus appears to depend not only on the presence of urease-producing micro-organisms but also on individual factors such as urinary composition.
