Published six times a year, the journal is available on subscription . Members of the European Association for Palliative Care qualify for a discounted subscription. The three most common primary sites are lung, breast and melanoma. After cranial irradiation the median survival period is 3-6 months. Patients present with symptoms of raised intracranial pressure - such as headache, vomiting and impaired consciousness, with focal neurological signs or convulsions.
Initial management is usually with steroids, to relieve oedema and reduce intracerebral pressure.
The treatment of morphine-induced constipation Nigel Sykes, Head of Medicine and Consultant in Palliative Care, St Christopher's Hospice, Sydenham, London, UK Constipation is one of the most troublesome adverse effects of morphine analgesia. Opioid-induced constipation cannot always be adequately controlled with conventional laxatives. Patients may therefore not accept the morphine doses that they need to control their pain. Other opioid antagonists under investigation are methyl nalorphine, methyl naltrexone and nalmefene glucuronide. Opioid antagonists may be effective in some cases of constipation not related to morphine.