ABSTRACT
During the last days of life the patient's weakness increases and mobility decreases, interest towards food and drink often vanishes, ability to swallow becomes weaker and drowsiness increases. The importance of good symptomatic treatment and support for the family will increase and the nature of the primary disease starts losing its significance. The nursing staff must have sensitivity towards the stress and anxiety of the patient or of the family and at the same time regularly assess and treat the patient's symptoms as well as inform close relatives about the changes in the patient's condition.
Subject(s)
Palliative Care/methods , Terminal Care/methods , Humans , Nurse's Role , Professional-Family RelationsABSTRACT
A prospective, randomized, double-blind study was designed to compare Clostridium difficile immune whey (CDIW) with metronidazole for treatment of laboratory-confirmed, recurrent, mild to moderate episodes of Clostridium difficile-associated diarrhoea (CDAD). CDIW was manufactured by immunization of cows in their gestation period with inactivated C. difficile vaccine. The resulting colostrum was processed, immunoglubulins were concentrated and the end-product containing high titres of C. difficile immunoglobulin was used as CDIW. 20 patients received metronidazole at a dosage of 400 mg t.i.d. and 18 patients CDIW 200 ml t.i.d. The study was interrupted early because of the bankruptcy of the sponsor. After 14 d of treatment, all 20 (100%) of 20 patients had responded to metronidazole therapy, compared with 16 (89%) of 18 who had received CDIW. 70 d after the beginning of treatment, sustained responses were observed in 11 (55%) of 20 patients receiving metronidazole and 10 (56%) of 18 patients treated with CDIW. In this preliminary study CDIW was as effective as metronidazole in the prevention of CDAD recurrences and it was well tolerated.
