Terminal Bleeding in Angiosarcoma.

Introduction: Terminal bleeding, a distressing symptom experience for patients, caregivers, and health professionals, occurs in a subset of patients in the palliative care setting. Terminal bleeding is often thought of as a large-volume catastrophically fatal event, but it can also occur for a longer period of time and still be the precipitating event for a patient's death. Case Report: We present the case of terminal bleeding in an 87-year-old patient with angiosarcoma, a rare aggressive vascular neoplasm that can occur anywhere in the body but tend to occur more frequently in the head and neck. Discussion: The patient's advanced age and aggressive disease presented challenges in managing the symptoms and precluded many of the conventional recommended interventions to manage bleeding. Conclusion: This case report speaks to the need for multidisciplinary planning that takes prognosis, performance status, previous therapies, and patient preferences into account when caring for patients with advanced cancer.

Influence of Linguistic and Nonlinguistic Variables on Generalization and Maintenance Following Phonomotor Treatment for Aphasia.

PURPOSE: Although phonomotor treatment shows promise as an effective intervention for anomia in people with aphasia, responses to this treatment are not consistent across individuals. To better understand this variability, we examined the influence of 5 participant characteristics-age, time postonset, aphasia severity, naming impairment, and error profile-on generalization and maintenance of confrontation naming and discourse abilities following phonomotor treatment. METHOD: Using retrospective data from 26 participants with aphasia who completed a 6-week phonomotor treatment program, we examined the relationships between participant characteristics of interest and change scores on confrontation naming and discourse tasks, measured pretreatment, immediately following treatment, and 3 months following treatment. RESULTS: Although the participant characteristics of aphasia severity and error profile appeared to predict generalization to improved confrontation naming of untrained items and discourse performance, a post hoc analysis revealed that no one characteristic predicted generalization across participants at 3 months posttreatment. CONCLUSIONS: Response to phonomotor treatment does not appear to be influenced by aphasia and anomia severity level, error profile, participant age, or time postonset. Other factors, however, may influence response to intensive aphasia treatment and are worthy of continued exploration.