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  1. Jason W Boland
  1. Senior Lecturer And Honorary Consultant In Palliative Medicine, Hull York Medical School, University Of Hull, and Care Plus Group and St Andrew's Hospice, North East Lincolnshire, UK

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Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients

▸ Kilgour RD, Vigano A, Trutschnigg B, et al. Support Care Cancer Published Online First: 20 Jul 2013.

The relationship between handgrip strength (HGS) and survival, quality of life, as well as biological markers, in 203 consecutive patients with advanced non-small cell lung and gastrointestinal cancers was evaluated. The patients were categorised into three HGS percentiles and using multivariate regression analyses the independent associations with HGS were calculated. When compared to patients with ≥50th percentile HGS, patients in the ≤10th percentile HGS had lower body mass index, haemoglobin, albumin, quality of life and performance status; more sarcopenia and fatigue, with an overall shorter survival. In view of these findings the authors suggest that patients presenting with very low HGS percentiles may require early referral to palliative care services.

The role of benzodiazepines in breathlessness: a single site, open label pilot of sustained release Morphine together with Clonazepam

▸ Allcroft P, Margitanovic V, Greene A, et al. J Palliat Med 2013;16:741–4.

This single site, open label pilot study assessed the safety and feasibility of adding regular clonazepam 0.5 mg nocte to regular oral 10 mg sustained release morphine sulfate mane in 11 people with chronic obstructive pulmonary disease and intensity of breathlessness ≥2 on the modified Medical Research Council Scale. Ten people completed 4 days (the efficacy outcome), five of whom reached the 15% reduction target in their baseline breathlessness intensity and three went on to the 10 day extension study, none of whom had adverse events. In view of these preliminary safety findings and the common use of benzodiazepines for this indication, the authors suggest that a larger controlled trial is warranted.

Oral morphine for cancer pain

▸ Wiffen PJ, Wee B, Moore RA. Cochrane Database Syst Rev 2013;(7):CD003868.

This further update of a Cochrane review, first published in 2003 and updated in 2007, aimed to determine the efficacy and toxicity of oral …

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