The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical Issuespatients’ needs. As was written by Sheila Cassidy, a British hospice physician, in her memoirSharing the Darkness:26 picas“Slowly, I learn about the importance of powerlessness. I experience it in my ownlife and I live with it in my work. The secret is not to be afraid of it – not to runaway. The dying know we are not God. All they ask is that we do not desert them.” 61Or, as expressed in the often-cited phrase attributed to Edward Trudeau (the Canadian physicianin the early 20 th century credited with developing the sanitarium system for tuberculosiscare long before the advent of disease-specific chemotherapy), the goal of the clinician for thepatient with an incurable, progressive and terminal illness is: “To cure never, to treat sometimes,to comfort always.”32U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau
A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical Issues26 picasREFERENCESII1. Centers for Disease Control. Mortality attributable to HIV infection/AIDS-United States, 1981-1990. MMWR40:41, 1991.2. Centers for Disease Control and Prevention. Update: Trends in AIDS incidence, deaths, and prevalence-United States, 1996. MMWR 46:165-173, 1997.3. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients withadvanced human immunodeficiency virus infection. N Engl J Med 338:853-60, 1998.4. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report. 12:1-44, 2000.5. Wong T, Chiasson A, Reggy A, Simonds RJ, Heffess K, Loo V. Antiretroviral therapy and declining AIDSmortality in New York City. J Urban Health 77:492-500, 2000.6. Chiasson MA, Berenson L, Li W, et al. Declining HIV/AIDS mortality in New York City.J Acquir Immun Defic Syndr 21:59-64, 1999.7. Egger M, Hirschel B, Francioli P, et al. Impact of new antiretroviral combination therapies on HIV infectedpatients in Switzerland: prospective multicentre study. BMJ 315:1194-9, 1997.8. Centers for Disease Control and Prevention. HIV and AIDS–United States, 1981-2000. MMWR 50:430-4, 2001.9. Selwyn PA, Goulet JL, Molde S, et al. HIV as a chronic disease: long-term care for patients with HIV at adedicated skilled nursing facility. J Urban Health 77:187-203, 2000.10. Lee L, Karon J, Selik R, Neal J, Fleming P. Survival after AIDS diagnosis in adolescents and adults during thetreatment era, United States, 1984-1997. JAMA 285:1308-15, 2001.11. Lynn J. Serving patients who may die soon and their families. JAMA 285:925-32, 2001.12. Sansone RG, Frengley JD. Impact of HAART on causes of death of persons with late-stage AIDS.J Urban Health 77:165-75, 2000.13. Puoti M, Spinetti A, Ghezzi A, et al. Mortality from liver disease in patients with HIV infection: a cohort study.J Acquir Immun Defic Syndr 24:211-7, 2001.14. www.cdc.gov/hiv, viewed 8/29/01.15. Kravcik S, Hawley-Foss N, Victor G, et al. Causes of death in HIV-infected persons in Ottowa, Ontario,1984-1995. Arch Intern Med 157:2069-73, 1997.16. Valdez H, Chowdhry TK, Asaad R, et al. Changing spectrum of mortality due to HIV: analysis of 260 deathsduring 1995-1999. Clin Infect Dis 32:1493, 2001.17. Selwyn PA, Arnold R. From fate to tragedy: the changing meanings of life, death, and AIDS.Ann Intern Med 129:899-902, 1998.18. World Health Organization. Cancer Pain Relief and Palliative Care, Report of a WHO Expert Committee.Publication 1100804. Geneva: World Health Organization, 1990.19. LaRue F, Colleau SM. Underestimation and undertreatment of pain in HIV disease: multicentre study.BMJ 314:23-8, 1997.20. Singer JE, Fahy-Chandon B, Chi S, Syndulko K, Tourtellotte WW. Painful symptoms reported by ambulatoryHIV-infected men in a longitudinal study. Pain 54:15-9, 1993.21. Breitbart W, Rosenfeld B, Passik SD, et al. The undertreatment of pain in ambulatory AIDS patients.Pain 65:243-9, 1996.22. O’Neill W, Sherrard J. Pain in human immunodeficiency virus disease: a review. Pain 54:3-14, 1993.U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 33
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Chapter 6.26 picasPulmonary Symptom
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Chapter 14.26 picasCulture and Care
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Chapter 15.26 picasSpecial Populati
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Chapter 17.26 picasEthical IssuesLy
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DRUGS AND THERAPIES INDEXNOTES: Ent
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