ABSTRACT
AIMS: Pain is among the most frequent and distressing symptoms in terminally-ill cancer and, to date, many patients still experience uncontrolled pain. In this paper we evaluated prevalence and intensity of pain on admission in our palliative care center and during the first three days of care. PATIENTS AND METHODS: From September 2009 to October 2009 we consecutively recruited 96 terminally-ill cancer patients : on admission more than 50% had severe pain and only 4% referred to be pain-free. 54% of patients was on treatment with strong opioids. RESULTS: After three days from admission in our palliative care unit only 7% of patients experienced severe pain, 25% reported absence of pain and 80% of patients was on treatment with strong opioids. CONCLUSIONS: The beginning of palliative care led to a meaningful and rapid reduction of pain in the vast majority of terminally-ill cancer patients evaluated in this study.
Subject(s)
Hospices , Neoplasms/physiopathology , Pain Measurement , Pain/diagnosis , Terminal Care/methods , Acetaminophen/administration & dosage , Acetaminophen/therapeutic use , Adult , Aged , Aged, 80 and over , Analgesics, Non-Narcotic/administration & dosage , Analgesics, Non-Narcotic/therapeutic use , Drug Therapy, Combination , Drug Utilization , Female , Humans , Italy/epidemiology , Male , Middle Aged , Narcotics/administration & dosage , Narcotics/therapeutic use , Neoplasms/therapy , Pain/drug therapy , Pain/epidemiology , Pain/etiology , Treatment OutcomeABSTRACT
PURPOSE: To compare the accuracy of the potential acuity meter (PAM) and the illuminated near card (INC) in patients undergoing phacoemulsification. METHODS: During presurgical evaluations, both PAM and INC were tested on each study patient following dilation. Patients then rated the subjective ease of use of each test. Best spectacle-corrected visual acuity (BSCVA) was recorded at 4 and 12 weeks postoperatively. McNemar's chi(2) test for paired associations was used to analyse categorical data; paired t-tests were used for continuous variables. RESULTS: Overall, the INC was more likely than the PAM to predict BSCVA within one Snellen line (P=0.002), but this difference decreased for accuracy within two lines. The PAM predicted BSCVA within one line in 87 (70.7%) eyes, as compared to 102 (82.9%) eyes by the INC. The PAM was accurate within two lines in 109 (88.6%) eyes; the INC was accurate in 115 (93.5%) eyes. The PAM was more likely to underpredict potential acuity (P<0.001), while the INC was more likely to overpredict (P=0.004) or give exact predictions of BSCVA (P<0.001). Accuracy of the INC declined in eyes with macular comorbidity. The PAM and INC were rated as 'easy' tests by 54 (45.4%) and 93 (78.2%) patients, respectively. CONCLUSIONS: Both the PAM and the INC were useful for predicting BSCVA after phacoemulsification, but the PAM was more likely to underestimate potential acuity. The INC was easier for patients to use, and had better accuracy than the PAM in patients without macular comorbidity, but was more likely to overestimate potential acuity.
Subject(s)
Phacoemulsification , Vision Tests/instrumentation , Adolescent , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Female , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Postoperative Period , Prospective Studies , Sensitivity and Specificity , Visual AcuityABSTRACT
Cases of functional bitemporal hemianopia rarely have been reported. The authors describe the case of a patient with dense bilateral inferotemporal quadrantic field defects on a functional basis that was confirmed by multifocal visual evoked potential. The normality of the multifocal visual evoked potential provides evidence of the functional basis of the field defects.
