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Titolo:
Palliative care in amyotrophic lateral sclerosis
Autore:
Borasio, GD; Voltz, R; Miller, RG;
Indirizzi:
Univ Munich, Hosp Grosshadern, Dept Neurol, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 Dept Neurol, D-81366 Munich, Germany Univ Munich, Hosp Grosshadern, Interdisciplinary Palliat Care Unit, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 at Care Unit, D-81366 Munich, Germany Calif Pacific Med Ctr, Dept Neurol, San Francisco, CA USA Calif Pacific Med Ctr San Francisco CA USA Neurol, San Francisco, CA USA Calif Pacific Med Ctr, Forbes Norris MDA ALS Ctr, San Francisco, CA USA Calif Pacific Med Ctr San Francisco CA USA LS Ctr, San Francisco, CA USA
Titolo Testata:
NEUROLOGIC CLINICS
fascicolo: 4, volume: 19, anno: 2001,
pagine: 829 -
SICI:
0733-8619(200111)19:4<829:PCIALS>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
MOTOR-NEURON DISEASE; PERCUTANEOUS ENDOSCOPIC GASTROSTOMY; POSITIVE-PRESSURE VENTILATION; TRANSDERMAL SCOPOLAMINE; MECHANICAL VENTILATION; EMOTIONAL LABILITY; PATIENT; QUALITY; ALS; GLYCOPYRROLATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
81
Recensione:
Indirizzi per estratti:
Indirizzo: Borasio, GD Univ Munich, Hosp Grosshadern, Dept Neurol, D-81366 Munich, Germany Univ Munich Munich Germany D-81366 , D-81366 Munich, Germany
Citazione:
G.D. Borasio et al., "Palliative care in amyotrophic lateral sclerosis", NEUROL CLIN, 19(4), 2001, pp. 829

Abstract

Amyotrophic lateral sclerosis (ALS) is the most common degenerative motor neuron disease in adults. The clinical picture consists of generalized fasciculations, progressive atrophy and weakness of the skeletal muscles, spasticity and pyramidal tract signs, dysarthria, dysphagia, and dyspnea. Pseudobulbar affect is common. Diseasespecific treatment options are still unsatisfactory Therapeutic nihilism is not justified as a large array of palliative measures available to enhance the quality of life of patients and their families. Because of its clinical characteristics, ALS represents a paradigm for palliative care in neurological diseases. Numerous projects are beingundertaken worldwide in an effort to enlarge the evidence base for palliative interventions in ALS. Palliative care in ALS is a multidisciplinary effort requiring careful coordination. An open and empathic disclosure of the diagnosis is essential. Nutritional deficiency caused by dyshagia can be relieved by a percutaneous endoscopic gastrostomy. Respiratory insufficiency can be effectively treated by non-invasive home mechanical ventilation. Theterminal phase of the disease should be discussed at the latest when symptoms of dyspnea appear, in order to prevent unwarranted fears of "choking todeath. " Psychological and spiritual care of patients and families are important. Collaboration with hospice institutions and completion of advance directives can be of invaluable help in the terminal phase.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/12/20 alle ore 21:56:33