A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Eduardo Bruera - Top 30 Publications

The challenges of providing rehabilitation for patients undergoing sacrectomy: two case reports.

Sacral neoplasms often present as large masses that often require sacrectomy. Multiple sacral nerve roots may be compromised post-sacrectomy and postoperative complications may result in impaired mobility, pain, orthostasis, and neurogenic bowel and bladder.

Pattern and Predictors of Outpatient Palliative Care Referral Among Thoracic Medical Oncologists.

There is significant variation in access to palliative care. We examined the pattern of outpatient palliative care referral among thoracic medical oncologists and identified oncologist characteristics associated with greater referral.

Practices, Attitudes, and Beliefs of Palliative Care Physicians Regarding the Use of Methadone and Other Long-Acting Opioids in Children with Advanced Cancer.

Palliative care physicians often assist with pain management in children with cancer, but little is known about how they use long-acting opioids for chronic pain with these patients.

Characteristics and Outcomes of Psychology Referrals in Palliative Care Department.

Psychologists can provide unique contributions to interdisciplinary palliative care. Despite research indicating high distress in palliative care cancer patients, little has been reported regarding the feasibility and practice of psychology in this setting.

Development and validation of a prognostic nomogram for ambulatory patients with advanced cancer.

Predicting survival of advanced cancer patients (ACPs) is a difficult task. We aimed at developing and testing a new prognostic tool in ACPs when they were first referred to palliative care (PC). A total of 497 patients were analyzed in this study (development sample, n = 221; validation sample, n = 276). From 35 initial putative prognostic variables, 14 of them were selected for multivariable Cox regression analyses; the most accurate final model was identified by backward variable elimination. Parameters were built into a nomogram to estimate the probability of patient survival at 30, 90, and 180 days. Calibration and discrimination properties of the Barretos Prognostic Nomogram (BPN) were evaluated in the validation phase of the study. The BPN was composed of 5 parameters: sex, presence of distant metastasis, Karnofsky Performance Status (KPS), white blood cell (WBC) count, and serum albumin concentration. The C-index was 0.71. The values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were 0.84, 0.74, and 0.74 at 30, 90, and 180 days, respectively. There were good calibration results according to the Hosmer-Lemeshow test. The median survival times were 313, 129, and 37 days for the BPN scores <25th percentile (<125), 25th to 75th percentile (125-175), and >75th percentile (>175), respectively (P < .001). The BPN is a new prognostic tool with adequate calibration and discrimination properties. It is now available to assist oncologists and palliative care physicians in estimating the survival of adult patients with advanced solid tumors.

Authors' Response.

Characteristics of Cancer Rehabilitation Fellowship Training Programs in the USA.

Cancer rehabilitation is emerging as a specialized field within Physical Medicine and Rehabilitation. The purpose of this systemic review is to summarize the various cancer rehabilitation fellowship programs in the USA and the scope of training in this discipline. Currently, four institutions offer such a training program. All of the fellowship directors were contacted about characteristics of their programs. The oldest program has been in existence since 2007. All of these programs are 1 year in duration and have between one and two fellowship positions annually. There have been total of 29 graduates as of July 2017. With regard to cancer rehabilitation care delivery model, all four centers reported inpatient consult teams and outpatient rehabilitation. Outpatient experience included electrodiagnosis, botulin toxin, and ultrasound-guided injections. Three of the four programs also reported the presence of an acute inpatient cancer rehabilitation service. A number of clinical rotations are available at each of the four programs with considerable variation. Comprehensive educational efforts are present in all programs with varying expectations for research.

Physicians' Compassion, Communication Skills, and Professionalism With and Without Physicians' Use of an Examination Room Computer: A Randomized Clinical Trial.

Methadone as the Initial Long-Acting Opioid in Children with Advanced Cancer.

Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects.

Bleeding frequency and characteristics among hematologic malignancy inpatient rehabilitation patients with severe thrombocytopenia.

To identify the frequency and characteristics of bleeding complications during acute inpatient rehabilitation of hematologic malignancy patients with severe thrombocytopenia.

Personalized Pain Goal as an Outcome Measure in Routine Cancer Pain Assessment.

There is currently no universally accepted outcome measure in cancer pain management. The personalized pain goal (PPG) has been shown to be a relevant outcome measure. We examined its use in routine outpatient practice and compared it with the clinically important difference (CID, ≥2 points or 30%), a pain outcome measure frequently used in several clinical studies.

The minimal clinically important difference of the Richmond Agitation-Sedation Scale in patients with cancer with agitated delirium.

The Richmond Agitation-Sedation Scale (RASS) is commonly used to assess psychomotor activity; however, to the authors' knowledge, its minimal clinically important difference (MCID) has not been determined to date. The objective of the current study was to identify the MCID for RASS using 2 anchor-based approaches.

Characteristics and Outcomes of Advanced Cancer Patients Who Received Palliative Care at a Public Hospital Compared with Those at a Comprehensive Cancer Center.

Patients with advanced cancer experience severe physical, psychosocial, and spiritual distress requiring palliative care (PC). There are limited literature regarding characteristics and outcomes of patients evaluated by PC services at public hospitals (PHs). Objective, Design, Setting/Subjects, and Measurements: To compare the outcomes of advanced cancer patients undergoing PC at a PH and those at a comprehensive cancer center (CCC). We reviewed 359 consecutive advanced cancer patients (PH, 180; CCC, 179) undergoing PC. Symptoms and outcomes at consultation and first follow-up visit were assessed. Summary statistics were used to describe patient characteristics and outcomes.

A Pragmatic Evaluation of Symptom Distress After Group Meditation for Cancer Patients and Caregivers: A Preliminary Report.

Complementary health approaches such as meditation may help improve cancer patient and caregiver symptoms, yet little research has examined the clinical application of these programs.

A research protocol for a pilot randomized controlled trial designed to examine the feasibility of a couple-based mind-body intervention for patients with metastatic lung cancer and their partners.

Given the generally incurable nature of metastatic non-small cell lung cancer (mNSCLC), patients and their romantic partners are at risk for existential/spiritual distress. Although a handful of dyadic psychosocial interventions for lung cancer patients and their caregivers exist, none of them target spiritual well-being. Informed by the mindfulness-based intervention literature and our pilot work in couples affected by lung cancer, we developed a brief couple-based mind-body (CBMB) intervention. The primary aim of this research protocol is to determine the feasibility of implementing the CBMB intervention versus an active control (AC) or wait list control (WLC) group in patients with mNSCLC and their partners using a randomized controlled trial design.

Characteristics of Unscheduled and Scheduled Outpatient Palliative Care Clinic Patients at a Comprehensive Cancer Center.

There is limited literature regarding outpatient palliative care and factors associated with unscheduled clinic visits.

Levorphanol for Treatment of Intractable Neuropathic Pain in Cancer Patients.

Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but responded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N-methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine. It bypasses hepatic first-pass metabolism and thereby not subjected to numerous drug interactions. Levorphanol's unique profile makes it a potentially attractive opioid in cancer pain management.

Serious Illness Conversations: Paving the Road with Metaphors.

Serious illness conversations can influence the direction of care by supporting decision-making compatible with the patient's goals. Effective use of core communication techniques, such as active listening and empathic statements, allows for a deeper understanding of the patients' goals, concerns, communication preferences, and questions. Metaphors can be used to augment end-of-life care planning. Used inappropriately, metaphors can cause misunderstandings and confusion. Applied skillfully, metaphors can personalize challenging discussions, improving patient comprehension and helping patients and their families to plan ahead. The art of communication is to use the right tool for the right person at the right time.

Mobility Functional Outcomes of Neurofibromatosis Patients: A Preliminary Report.

The aim of the study was to describe the mobility outcomes of neurofibromatosis (NF) patients who received acute inpatient rehabilitation.

Decisional control preferences among patients with advanced cancer: An international multicenter cross-sectional survey.

Understanding patients' decision control preferences is important in providing quality cancer care. Patients' decisional control preference can be either active (patients prefer to make decisions themselves), shared (collaborative between patient, their physician, and/or family), or passive (patients prefer that the decisions are made by either the physician and/or their family).

A Comparison of the Accuracy of Clinician Prediction of Survival Versus the Palliative Prognostic Index.

Survival predictions for advanced cancer patients impact many aspects of care, but the accuracy of clinician prediction of survival (CPS) is low. Prognostic tools such as the Palliative Prognostic Index (PPI) have been proposed to improve accuracy of predictions. However, it is not known if PPI is better than CPS at discriminating survival.

Pilot Testing of a Brief Couple-Based Mind-Body Intervention for Patients With Metastatic Non-Small Cell Lung Cancer and Their Partners.

Given the generally incurable nature of metastatic lung cancer, patients and their spouses/partners are at risk for psychological and spiritual distress. To address this concern, we developed a couple-based mind-body (CBMB) intervention.

Perception of Curability Among Advanced Cancer Patients: An International Collaborative Study.

There are limited data on illness understanding and perception of cure among advanced cancer patients around the world. The aim of the study was to determine the frequency and factors associated with inaccurate perception of curability among advanced cancer patients receiving palliative care across the globe.

Factors Associated With Attrition in a Multicenter Longitudinal Observational Study of Patients With Advanced Cancer.

Attrition is common in longitudinal observational studies in palliative care. Few studies have examined predictors of attrition.

Timing of Referral and Characteristics of Uninsured, Medicaid, and Insured Patients Referred to the Outpatient Supportive Care Center at a Comprehensive Cancer Center.

Low-income patients face barriers to palliative care access, which might negatively influence symptom management and advanced care planning.

The Effect of Message Content and Clinical Outcome on Patients' Perception of Physician Compassion: A Randomized Controlled Trial.

In a previous randomized crossover study, patients perceived a physician delivering a more optimistic message (MO) as more compassionate and professional. However, the impact of the clinical outcome of the patient on patient's perception of physician's level of compassion and professionalism has not been previously studied. Our aim was to determine if the reported clinical outcome modified the patient's perception of physician compassion, professionalism, impression, and preference for physician.

Methadone as a First-Line Opioid in Cancer Pain Management: A Systematic Review.

The objective of this review was to assess the existent evidence for the use of methadone as a first-line therapy in cancer pain management.

Decisional control preferences of patients with advanced cancer receiving palliative care.

Understanding patients' decisional control preferences (DCPs) is important to improving the quality of care and the satisfaction of patients who have advanced cancer with their care. In addition to passive decisional control (i.e., the patient prefers his/her doctor or family caregiver to make a decision on their behalf) and active decisional control (i.e., the patient decides alone), shared decisional control, where patients and caregivers decide together, could be more appropriate. The primary aim of our study was to describe the decision-making process and the DCPs of patients with advanced cancer receiving palliative care in France.

Adolescent-young adults (AYA) with cancer seeking integrative oncology consultations: demographics, characteristics, and self-reported outcomes.

Integrative Oncology (IO) consultations offer cancer patients counseling regarding complementary integrative medicine (CIM). We explored the CIM interests and symptom burden of AYA cancer patients presenting for an IO consultation.

Palliative radiation therapy in the last 30 days of life: A systematic review.

To investigate the utilization of palliative radiation therapy (RT), predictors for the use of RT, and symptom palliation following RT during the last 30 days of life through systemic review of literature.