Adolescent ; Diseases in Twins ; Female ; Humans ; Hyperthyroidism ; Pregnancy ; Twins, Monozygotic

Adolescent ; Adult ; Aged ; Albuterol ; pharmacology ; therapeutic use ; Asthma ; drug therapy ; Child ; Female ; Heart Rate ; drug effects ; Humans ; Male ; Middle Aged ; Terbutaline ; pharmacology ; therapeutic use

Child ; Humans ; Infant ; Intestines ; abnormalities ; surgery ; Male

Adult ; Female ; Humans ; Pleural Diseases ; pathology ; Sarcoidosis ; pathology

Administration, Oral ; Arrhythmias, Cardiac ; drug therapy ; Bradycardia ; drug therapy ; Heart Block ; drug therapy ; Humans ; Infusions, Parenteral ; Metaproterenol ; administration & dosage ; therapeutic use

Adolescent ; Adult ; Asthma ; drug therapy ; Czechoslovakia ; History of Medicine ; Humans ; Injections, Subcutaneous ; Isoquinolines ; administration & dosage ; Mental Disorders ; drug therapy ; Psychiatry ; history ; Terbutaline ; administration & dosage ; therapeutic use ; Tranquilizing Agents ; history ; therapeutic use ; Tretoquinol ; administration & dosage ; therapeutic use

Adult ; Airway Obstruction ; physiopathology ; Asthma ; physiopathology ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged

Administration, Topical ; Adolescent ; Adult ; Aerosols ; Anti-Inflammatory Agents ; administration & dosage ; Asthma ; drug therapy ; Beclomethasone ; administration & dosage ; therapeutic use ; Female ; Glucocorticoids ; Humans ; Male ; Middle Aged ; Prednisolone ; administration & dosage ; therapeutic use ; Time Factors

INTRODUCTIONThis study aimed to describe the patterns of sedative use among terminally ill cancer patients who were referred to a hospital-based specialist palliative care service for symptom management. It also aimed to examine whether sedative use among terminally ill cancer patients during the last two days of life had any impact on their survival.

METHODSA retrospective review of case notes was carried out for patients with a diagnosis of terminal cancer, who died in a 95-bedded oncology ward between September 2006 and September 2007. Data was collected on patient characteristics, duration of palliative care, indications and doses of sedatives used at 48 hours and 24 hours before death.

RESULTSA total of 238 patients died while receiving specialist palliative care, 132 of whom (55.5%) were female. At 48 hours and 24 hours before death, 22.6% and 24.8% of patients, respectively, were on sedatives like midazolam, haloperidol or both. The median dose of midazolam was 5 mg/day while the haloperidol dose at 48 hours and 24 hours before death was 3 mg/day and 4 mg/day, respectively. The indications for midazolam were anxiety, breathlessness and stiffness, while those for haloperidol were confusion agitation and nausea. Survival analysis showed no significant difference in survival between patients who were on sedatives and those who were not. The p-value for log-rank test was 0.78.

CONCLUSIONThe results showed that the doses and overall frequency of sedative use in this patient population tended to be low and that usage of sedatives had no deleterious influence on survival.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesics, Opioid ; therapeutic use ; Female ; Haloperidol ; therapeutic use ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Midazolam ; therapeutic use ; Middle Aged ; Neoplasms ; drug therapy ; mortality ; Palliative Care ; methods ; Retrospective Studies ; Terminal Care ; methods ; Terminally Ill ; Time Factors ; Treatment Outcome

Endoscopy ; methods ; Female ; Foreign Bodies ; Humans ; Male ; Urinary Bladder ; pathology