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Article ; Online: Modern management of malignant hypercalcemia.

Legrand, Susan B

The American journal of hospice & palliative care

2011 Volume 28, Issue 7, Page(s) 515–517

Abstract: Hypercalcemia occurs in 10% to 20% of those with advanced cancer. It is considered an oncologic emergency. Presenting symptoms include common gastrointestinal symptoms that may be difficult to differentiate from tumor or treatment-related symptoms. These ...

Abstract	Hypercalcemia occurs in 10% to 20% of those with advanced cancer. It is considered an oncologic emergency. Presenting symptoms include common gastrointestinal symptoms that may be difficult to differentiate from tumor or treatment-related symptoms. These include nausea, vomiting, and constipation. As levels increase or if development is rapid, neuropsychiatric symptoms such as delirium can develop. Untreated it will lead to coma and death. Current preferred therapies are the bisphosphonate agents, zoledronate and pamidronate with saline rehydration.
MeSH term(s)	Bone Density Conservation Agents/therapeutic use ; Calcitonin/therapeutic use ; Clinical Protocols ; Diphosphonates/therapeutic use ; Fluid Therapy ; Gallium/therapeutic use ; Humans ; Hypercalcemia/diagnosis ; Hypercalcemia/drug therapy ; Hypercalcemia/etiology ; Hypercalcemia/physiopathology ; Imidazoles/therapeutic use ; Neoplasms/complications ; Palliative Care ; Parathyroid Hormone-Related Protein/metabolism
Chemical Substances	Bone Density Conservation Agents ; Diphosphonates ; Imidazoles ; Parathyroid Hormone-Related Protein ; zoledronic acid (6XC1PAD3KF) ; Calcitonin (9007-12-9) ; Gallium (CH46OC8YV4) ; pamidronate (OYY3447OMC) ; gallium nitrate (VRA0C6810N)
Language	English
Publishing date	2011-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909111414164
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Article ; Online: Delirium in palliative medicine: a review.

LeGrand, Susan B

Journal of pain and symptom management

2012 Volume 44, Issue 4, Page(s) 583–594

Abstract: Delirium is a devastating complication of general medical and surgical populations but of particular importance in palliative medicine. It is a clinical syndrome that is often not recognized and, therefore, not treated appropriately. The presence of ... ...

Abstract	Delirium is a devastating complication of general medical and surgical populations but of particular importance in palliative medicine. It is a clinical syndrome that is often not recognized and, therefore, not treated appropriately. The presence of delirium is a predictor of increased morbidity and mortality, longer hospitalization, and more likely discharge to a nursing facility. This article reviews the pathophysiology, etiology, diagnosis, and treatment of delirium in the palliative medicine population.
MeSH term(s)	Delirium/diagnosis ; Delirium/therapy ; Humans ; Palliative Care/psychology ; Risk Factors ; Terminally Ill/psychology
Language	English
Publishing date	2012-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2011.10.013
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Zs.A 2252: Show issues

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Article ; Online: Palliative medicine fellowship: a study of resident choices.

Legrand, Susan B / Heintz, Jessica B

Journal of pain and symptom management

2012 Volume 43, Issue 3, Page(s) 558–568

Abstract: Context: There are no data on the motives or characteristics of physicians choosing fellowship training in Hospice and Palliative Medicine (HPM).: Objectives: To understand more about the residents who choose HPM and what leads them to this decision.! ...

Abstract	Context: There are no data on the motives or characteristics of physicians choosing fellowship training in Hospice and Palliative Medicine (HPM). Objectives: To understand more about the residents who choose HPM and what leads them to this decision. Methods: An electronic survey of HPM fellows initiating training in July 2009. Results: Seventy-six physicians began the study, with 62 responders (82%) completing all questions. Fifty-five percent were aged 30-40 years, and 61% were female. Sixty-eight percent were non-Hispanic Caucasian, 24% were Asian, and none were African American. Fifty-five percent were trained in internal medicine. Most (86%) asserted that the care of a dying, critically ill, or symptomatic person impacted their decision to enter the field of HPM. Sixty-three percent did not feel prepared to manage dying patients, and 41% felt personal regret about the care they delivered. The major reasons for choosing the specialty were a desire to contribute to relief of suffering (79%), enhance end-of-life care (73%), and improve communication (78%). Ninety-five percent received negative comments about their career choice. Fifty-nine percent had no exposure to hospice or palliative medicine in medical school, whereas 61% had an exposure available during residency. Forty-seven percent decided to enter a fellowship in the third year of residency, and 33% applied after practicing in their primary specialty for a median of 10 years. Accreditation, strength of education, and a hospital palliative medicine service were required by the majority for selection of a fellowship program. Conclusion: Negative experiences with end-of-life care in residency, particularly in the intensive care unit, continue to be a factor in selection of HPM as a specialty. Many residents make their decision to enter the field and apply during Postgraduate Year 3. Most received negative comments about the choice. Fellows require a broad range of experience when selecting a fellowship program.
MeSH term(s)	Adult ; Data Collection ; Databases, Factual ; Education, Medical, Graduate/statistics & numerical data ; Fellowships and Scholarships ; Female ; Hospices ; Humans ; Internal Medicine/education ; Internship and Residency ; Male ; Middle Aged ; Motivation ; Palliative Care ; Specialization
Language	English
Publishing date	2012-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2011.04.018
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Article ; Online: Nausea and vomiting in advanced cancer.

Gordon, Pamela / LeGrand, Susan B / Walsh, Declan

European journal of pharmacology

2014 Volume 722, Page(s) 187–191

Abstract: Nausea and vomiting are very common symptoms in cancer both treatment and non-treatment related. Many complications of advanced cancer such as gastroparesis, bowel and outlet obstructions, and brain tumors may have nausea and vomiting or either symptom ... ...

Abstract	Nausea and vomiting are very common symptoms in cancer both treatment and non-treatment related. Many complications of advanced cancer such as gastroparesis, bowel and outlet obstructions, and brain tumors may have nausea and vomiting or either symptom alone. In a non-obstructed situation, nausea may be more difficult to manage and is more objectionable to patients. There is little research on management of these symptoms except the literature on chemotherapy induced nausea where guidelines exist. This article will review the etiologies of nausea and vomiting in advanced cancer and the medications which have been used to treat them. An etiology based protocol to approach the symptom is outlined.
MeSH term(s)	Humans ; Nausea/chemically induced ; Nausea/complications ; Nausea/drug therapy ; Nausea/therapy ; Neoplasms/complications ; Neoplasms/drug therapy ; Vomiting/chemically induced ; Vomiting/complications ; Vomiting/drug therapy ; Vomiting/therapy
Language	English
Publishing date	2014-01-05
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	80121-5
ISSN	1879-0712 ; 0014-2999
ISSN (online)	1879-0712
ISSN	0014-2999
DOI	10.1016/j.ejphar.2013.10.010
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Zs.A 522: Show issues

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Article ; Online: Real-World Outcomes of Everolimus and Exemestane for the Treatment of Metastatic Hormone Receptor-Positive Breast Cancer in Patients Previously Treated With CDK4/6 Inhibitors.

Mo, Hanjie / Renna, Catherine E / Moore, Halle C F / Abraham, Jame / Kruse, Megan L / Montero, Alberto J / LeGrand, Susan B / Wang, Lu / Budd, G Thomas

Clinical breast cancer

2021 Volume 22, Issue 2, Page(s) 143–148

Abstract: Purpose: Everolimus with exemestane (EVE+EXE) was FDA-approved to treat metastatic hormone receptor-positive breast cancer (mHRBC) based on BOLERO-2. However, none of those patients received prior CDK4/6 inhibitors. The purpose of this study is to ... ...

Abstract	Purpose: Everolimus with exemestane (EVE+EXE) was FDA-approved to treat metastatic hormone receptor-positive breast cancer (mHRBC) based on BOLERO-2. However, none of those patients received prior CDK4/6 inhibitors. The purpose of this study is to evaluate the efficacy of EVE+EXE in mHRBC after CDK4/6 inhibitors. Methods: A retrospective review of patients ≥18 years old with mHRBC treated with EVE+EXE, for ≥30 days, at our institution from January 1, 2012, to April 1, 2020 was conducted. Primary objective was to compare progression free survival (PFS) for EVE+EXE between patients with and without prior exposure to CDK4/6 inhibitors. Secondary outcomes included overall survival and safety. Results: 192 patients were included in the study (n = 79, prior CDK4/6 inhibitor use; n = 113, no prior CDK4/6 inhibitor use). Baseline patient characteristics were similar between groups. Greater number of prior therapies before EVE+EXE use increased risk of disease progression (P = .017). Patients with prior CDK4/6 inhibitor use had a lower median PFS of 3.8 months (95% CI: 3.4-4.7) vs. 5.4 months (95% CI: 3.9-6.2) for patients without prior CDK4/6 inhibitor use, with a HR for progression of 1.46 (95% CI: 1.08 to 1.97, P = .013). Overall survival between groups was not significantly different. Conclusion: Patients who received a prior CDK4/6 inhibitor had a lower median PFS benefit from EVE+EXE compared to those who did not, without differences in overall survival. Although PFS is expected to decrease with subsequent lines of therapy, it is reasonable to use EVE+EXE after CDK4/6 inhibitors in selected patients, recognizing that additional benefit is modest.
MeSH term(s)	Adolescent ; Adult ; Aged ; Androstadienes/therapeutic use ; Antineoplastic Agents/therapeutic use ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Everolimus/therapeutic use ; Female ; Humans ; Middle Aged ; Quality of Life ; Receptor, ErbB-2/drug effects ; Receptor, ErbB-2/metabolism ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Androstadienes ; Antineoplastic Agents ; Everolimus (9HW64Q8G6G) ; Receptor, ErbB-2 (EC 2.7.10.1) ; exemestane (NY22HMQ4BX)
Language	English
Publishing date	2021-10-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2106734-X
ISSN	1938-0666 ; 1526-8209
ISSN (online)	1938-0666
ISSN	1526-8209
DOI	10.1016/j.clbc.2021.10.002
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Zs.A 5800: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 498: Show issues

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Article ; Online: CPR for patients labeled DNR.

LeGrand, Susan B

Annals of internal medicine

2003 Volume 139, Issue 8, Page(s) 704; author reply 705

MeSH term(s)	Cardiopulmonary Resuscitation ; Decision Making ; Humans ; Patients ; Resuscitation Orders
Language	English
Publishing date	2003-10-21
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-139-8-200310210-00024
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Article ; Online: Physicians and patient spirituality.

LeGrand, Susan B

Annals of internal medicine

2002 Volume 137, Issue 5 Part 1, Page(s) 372; author reply 372

MeSH term(s)	Humans ; Office Visits ; Physician-Patient Relations ; Religion ; Spirituality
Language	English
Publishing date	2002-09-03
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-137-5_part_1-200209030-00028
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Article: Cancer fatigue--more data, less information?

LeGrand, Susan B

Current oncology reports

2002 Volume 4, Issue 4, Page(s) 275–279

MeSH term(s)	Anemia/etiology ; Central Nervous System Stimulants/therapeutic use ; Chronic Disease ; Cytokines/blood ; Depression/etiology ; Exercise ; Fatigue/blood ; Fatigue/etiology ; Fatigue/physiopathology ; Fatigue/therapy ; Humans ; Interferons/blood ; Methylphenidate/therapeutic use ; Neoplasms/blood ; Neoplasms/complications ; Neoplasms/physiopathology ; Quality of Life
Chemical Substances	Central Nervous System Stimulants ; Cytokines ; Methylphenidate (207ZZ9QZ49) ; Interferons (9008-11-1)
Language	English
Publishing date	2002-05-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2057359-5
ISSN	1523-3790
ISSN	1523-3790
DOI	10.1007/s11912-002-0001-7
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Article: Dyspnea: the continuing challenge of palliative management.

LeGrand, Susan B

Current opinion in oncology

2002 Volume 14, Issue 4, Page(s) 394–398

Abstract: The management of dyspnea is a challenge even for the most experienced palliative medicine teams. In the absence of effective treatment for the underlying disease, therapeutic options are limited to the supplementation of oxygen, the use of opioids, and ... ...

Abstract	The management of dyspnea is a challenge even for the most experienced palliative medicine teams. In the absence of effective treatment for the underlying disease, therapeutic options are limited to the supplementation of oxygen, the use of opioids, and multidisciplinary nonpharmacologic interventions. There is increased research into both the physiology of dyspnea and the correlates of the symptom in advanced disease. Hopefully, this research will lead to improved therapy in the future. This article reviews current literature on dyspnea with a focus on publications in 2001.
MeSH term(s)	Dyspnea/etiology ; Dyspnea/physiopathology ; Dyspnea/therapy ; Humans ; Lung Neoplasms/complications ; Narcotics/therapeutic use ; Oxygen Inhalation Therapy ; Palliative Care ; Respiratory Insufficiency ; Terminal Care
Chemical Substances	Narcotics
Language	English
Publishing date	2002-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1049384-0
ISSN	1531-703X ; 1040-8746
ISSN (online)	1531-703X
ISSN	1040-8746
DOI	10.1097/00001622-200207000-00004
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Article ; Online: Comfort measures: practical care of the dying cancer patient.

LeGrand, Susan B / Walsh, Declan

The American journal of hospice & palliative care

2010 Volume 27, Issue 7, Page(s) 488–493

Abstract: Most patients with advanced malignancy will die of their disease. Care of the dying is therefore a fundamental skill for the oncologist. Although protocols exist in other countries, there is no established protocol in the United States. We present a ... ...

Abstract	Most patients with advanced malignancy will die of their disease. Care of the dying is therefore a fundamental skill for the oncologist. Although protocols exist in other countries, there is no established protocol in the United States. We present a protocol for management of the dying that is clinically useful and review the existing evidence-base.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Colonic Neoplasms/complications ; Colonic Neoplasms/drug therapy ; Female ; Humans ; Middle Aged ; Pain, Intractable/drug therapy ; Palliative Care/methods ; Patient Care Planning/organization & administration ; Quality of Life ; Terminal Care/methods
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2010-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909110380200
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