A prospective observational study on chemotherapy-induced nausea and vomiting for esophageal cancer patients in Japan.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 135-135
Author(s):  
Sachiko Yamamoto ◽  
Ryu Ishihara ◽  
Naoya Yoshida ◽  
Hideaki Shimada ◽  
Tsuyoshi Noguchi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Observational Study ◽  
Acute Phase ◽  
Predictive Factors ◽  
Odds Ratio ◽  
Late Phase ◽  
Multivariate Logistic Regression Analysis ◽  
Nausea And Vomiting ◽  
Current Status ◽  
Antiemetic Drugs

135 Background: Chemotherapy-induced nausea and vomiting (CINV) is still one of the major problems in cancer treatment. However detailed profile of CINV in patients with esophageal cancer is not known. Prospective multi-center observational study was conducted to assess the current status of CINV in Japan. Methods: Between May 2011 and December 2012, 193 patients with esophageal cancer who underwent systemic chemotherapy with high (HEC) or moderate emetogenic agents (MEC) were registered. Antiemetic drugs (5-HT3 receptor antagonists, dexamethasone and NK1receptor antagonist) were used to suppress CINV. Occurrence and severity of CINV were assessed with a diary provided to the patients prior to chemotherapy. Acute phase (within 24 hours from the start of chemotherapy) and late phase CINV (24 hours or later) were assessed separately. Multivariate logistic regression analysis was conducted to identify the predictive factors for acute and late phase CINV. Results: Of 193 patients 165 were male and 28 were female. Median age was 66 (range 40-84). HEC and MEC were administered in 180 and 13 patients, respectively. Acute phase nausea and vomiting were observed in 9 (4.7%) and 7 (3.6%) of 193 patients, respectively. Late-phase nausea and vomiting were observed in 75 (38.9%) and 18 (9.3%) of 193 patients, respectively. Risk factors for acute phase nausea, acute phase vomiting, late phase nausea and late-phase vomiting were assessed separately. By multivariate analysis for late-phase vomiting, younger age (Odds ratio 0.523 [every 10 years]; 95%CI 0.278-0.986; p=0.045) and male gender (Odds ratio 5.796; 95%CI 1.806-18.603; p=0.003) were independent predictive factors. By multivariate analyses for acute phase nausea, acute phase vomiting and late-phase nausea, no independent predictive factor was identified. Conclusions: Acute phase CINV was effectively suppressed by antiemetic drugs, while late phase CINV was not sufficiently suppressed. Further intervention to suppress late phase CINV should be considered, especially in high-risk patients. Clinical trial information: UMIN000005971.

scholarly journals The prevention and treatment of chemotherapy-induced nausea and vomiting in children and adolescents receiving cancer treatment: the current status and possibilities for improvement

2020 ◽  
Vol 19 (4) ◽  
pp. 205-223
Author(s):  
N. V. Zhukov ◽  
L. L. Kazakova ◽  
G. A. Novichkova
Keyword(s):  
Cancer Treatment ◽  
Children And Adolescents ◽  
Nausea And Vomiting ◽  
Pediatric Care ◽  
Current Status ◽  
Antiemetic Prophylaxis ◽  
Antiemetic Drugs ◽  
Prevention And Treatment ◽  
Life Threatening ◽  
Drug Studies

Even though chemotherapy-induced nausea and vomiting (CINV) rarely become life-threatening, they are regarded by patients as one of the most unbearable complications and can often cause great suffering. CINV may also be an aggravating factor for other complications and pathological conditions. The currently available antiemetic prophylaxis can greatly reduce the incidence of CINV in children and adolescents receiving cancer treatment. However, inadequate management of CINV is still much more common in children than in adults, and the integration of new antiemetic drugs into pediatric care is delayed because of specific regulatory requirements for drug studies in children. The aim of this article is to present current standards for prevention and treatment of CINV in children and adolescents as well as to suggest ways to improve them.

scholarly journals Response to Transforaminal Epidural Block as a Useful Predictive Factor of Postherpetic Neuralgia

2019 ◽  
Vol 8 (3) ◽  
pp. 323 ◽  
Author(s):  
JungHyun Park ◽  
Su Baek ◽  
So Baek ◽  
Eung Kim
Keyword(s):  
Herpes Zoster ◽  
Acute Phase ◽  
Predictive Factors ◽  
Predictive Factor ◽  
Postherpetic Neuralgia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Multivariate Logistic Regression Analysis ◽  
Epidural Block ◽  
Co Morbidity

Despite the high frequency of nerve blocks in the acute phase of herpes zoster, factors associated with intervention, such as response to epidural block, have not been analyzed as predictive factors of postherpetic neuralgia (PHN). To determine the predictive factors of progression to PHN in the presence of interventions, we analyzed the medical records of 145 patients who underwent transforaminal epidural injection (TFEI) in the acute phase of herpes zoster. A total volume of 5 mL (a mixture of 0.5% lidocaine and 5 mg dexamethasone) was injected during TFEI. Corticosteroid was used only for the first TFEI. Clinical data of age, sex, involved dermatome, presence of comorbidity, time from zoster onset to first TFEI, numerical rating scale (NRS) before TFEI, NRS at 1 week and 1, 3, and 6 months after the first TFEI, and number of TFEI were collected and analyzed. Through multivariate logistic regression analysis, pain improvement less than 50% at 1 week after the first TFEI was a strong predictive factor of progression of PHN at all time points. Response to TFEI appears to be a stronger predictive factor of progression to PHN than patient factors of sex, age, degree of initial pain, and presence of co-morbidity.

scholarly journals Impact of Blood Type O on Mortality of Sepsis Patients: A Multicenter Retrospective Observational Study

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 826
Author(s):  
Daisuke Hasegawa ◽  
Kazuki Nishida ◽  
Takahiro Kawaji ◽  
Yoshitaka Hara ◽  
Yasuyo Shimomura ◽  
...  
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Odds Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Blood Type ◽  
Retrospective Observational Study ◽  
Blood Types ◽  
Potential Risk Factors ◽  
Sepsis And Septic Shock ◽  
The Impact

ABO blood groups have been implicated as potential risk factors for various diseases. However, no study has investigated the association between sepsis mortality and ABO blood types. We aimed to evaluate the impact of these blood types on mortality in patients with sepsis and septic shock. This retrospective observational study was conducted at two general hospitals in Japan. Patients diagnosed with sepsis or septic shock were included and divided into four groups based on blood type (O, A, B, and AB). The association between type O vs. other types and 28- and 90-day mortalities was evaluated using multivariate logistic regression analysis adjusted for age, sex, and Sequential (Sepsis-related) Organ Failure Assessment score. This study included 415 patients, of whom 131 (31.6%), 171 (41.2%), 81 (19.5%), and 32 (7.7%) had type O, A, B, and AB, respectively. Blood type O was not associated with 28-day (odds ratio: 1.7 p = 0.08) or 90-day mortality (odds ratio: 1.53, p = 0.091). However, type O was significantly associated with higher 90-day mortality (odds ratio: 3.26, p = 0.009) in patients with septic shock. The role of ABO blood type in risk stratification for septic shock and the mechanisms that potentially affect the prognosis of sepsis patients need further investigation.

scholarly journals The efficacy of serum copeptin and zinc-alpha2-glycoprotein for predictors of tolvaptan treatment in decompensated cirrhotic patients

2020 ◽  
Author(s):  
Ryuta Shigefuku ◽  
Motoh Iwasa ◽  
Akiko Eguchi ◽  
Mina Tempaku ◽  
Yasuyuki Tamai ◽  
...  
Keyword(s):  
Body Weight ◽  
Treatment Group ◽  
Cystatin C ◽  
Predictive Factors ◽  
Odds Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Predictive Ability ◽  
Refractory Ascites ◽  
Decompensated Liver Cirrhosis ◽  
Fatty Acid Binding

Abstract Aim The efficacy of tolvaptan, an orally active vasopressin V2-receptor antagonist, has recently been reported in patients with refractory ascites unresponsive to conventional diuretics. However, the effect of tolvaptan varies among patients. Recently, the prognostic role of tolvaptan response in decompensated liver cirrhosis (LC) is also attracts attention. Our aim is to elucidate predictive factors using serum copeptin (vasopressin precursor), zinc-α2-glycoprotein (ZAG), cystatin C (renal biomarker), neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP) that portend a good response to tolvaptan in LC patients with ascites. Methods We enrolled 113 LC patients and divided into tolvaptan treatment group and non-treatment group. Tolvaptan (3.75 or 7.5 mg/day) was administrated to 38 LC patients with ascites and a follow-up assessment occurred after a 7-day tolvaptan treatment regimen. Results We revealed predictive ability for kidney and/or liver damage in serum copeptin, ZAG, cystatin C, NGAL and L-FABP levels in all patients. Post 7-day tolvaptan treatment, 19 patients lost more than 1.5 kg of their body weight (Responders), while 19 patients did not change their body weight significantly (Non-responders). Basal blood urea nitrogen (BUN) levels (p = 0.0014), serum copeptin (p = 0.0265) and serum ZAG levels (p = 0.0142) were significantly higher in the Non-responders. BUN (odds ratio 7.43, p = 0.0306), copeptin (odds ratio 9.12, p = 0.0136) and ZAG (odds ratio 7.43, p = 0.0306) were determined to be predictive factors of drug responsiveness using multivariate logistic regression analysis. Conclusion Serum BUN, copeptin and ZAG levels predict patient response to tolvaptan even when measured prior to treatment.

Contribution of Dexamethasone to Control of Chemotherapy-Induced Nausea and Vomiting: A Meta-Analysis of Randomized Evidence

2000 ◽  
Vol 18 (19) ◽  
pp. 3409-3422 ◽  
Author(s):  
John P. A. Ioannidis ◽  
Paul J. Hesketh ◽  
Joseph Lau
Keyword(s):  
Acute Phase ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Nausea And Vomiting ◽  
Design Parameters ◽  
Delayed Emesis ◽  
Complete Protection ◽  
Acute Emesis ◽  
Delayed Nausea ◽  
Delayed Phase

PURPOSE: To synthesize the available randomized evidence on the efficacy of dexamethasone when used for protection against acute and delayed nausea and vomiting in patients receiving highly or moderately emetogenic cancer chemotherapy. MATERIALS AND METHODS: A meta-analysis was performed using trials identified through MEDLINE (1966 to April 1999), Embase, Derwent Drug File, and the Cochrane Library’s Database of Controlled Trials. Data on acute and delayed emesis and nausea were collected. All randomized studies comparing dexamethasone to placebo, no treatment, or other antiemetics qualified, including cross-over trials providing first-cycle data. RESULTS: Of 1,200 citations screened, 32 studies with 42 pertinent comparisons and 5,613 patients were included in the meta-analysis. Dexamethasone was superior to placebo or no treatment for complete protection from acute emesis (odds ratio, 2.22; 95% confidence interval [CI], 1.89 to 2.60) and for complete protection from delayed emesis (odds ratio, 2.04; 95% CI, 1.63 to 2.56). The results were similar for complete protection from nausea. The pooled risk difference for complete protection from emesis was 16% for both the acute and delayed phases (95% CI, 13% to 19% and 11% to 20%, respectively). The beneficial effect was similar in subgroups defined by various study design parameters. No trial addressed the efficacy of dexamethasone in the delayed phase without having administered dexamethasone for acute-phase protection as well. CONCLUSION: Dexamethasone is clearly effective in protecting from emesis both in the acute and delayed phases, with emesis avoided in one patient out of six treated. Future trials should determine whether the delayed-phase effect is independent of the acute-phase benefit.

The effect of foot reflexology on chemotherapy-induced nausea and vomiting in digestive or lung cancer patients: a randomized controlled trial (Preprint)

2020 ◽  
Author(s):  
Audrey Murat-Ringot ◽  
Pierre Jean Souquet ◽  
Fabien Subtil ◽  
Florent Boutitie ◽  
Marie Preau ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Controlled Trial ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Digestive Cancer ◽  
Complementary Medicines ◽  
Antiemetic Drugs ◽  
Platinum Based Chemotherapy ◽  
Significant Difference ◽  
Delayed Nausea

BACKGROUND Cancer is a chronic disease with an incident worldwide had been 24.5 million and 9.6 million deaths in 2017. Lung and colorectal cancer are the most common cancer for both sexes and according to national and international recommendations platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting may persist. Moreover, cancer patient are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology decreases significantly the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. OBJECTIVE The primary objective of the present study was to assess the benefits of foot reflexology as a complement to conventional treatments on severity of acute chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed were the frequency and severity of delayed chemotherapy-induced nausea and vomiting, quality of life, anxiety, and self-esteem. METHODS The present study was conducted between April 2018 and April 2020 in French University Hospital. This is an open-label randomized controlled trial. Participants are randomized into two groups: 40 to interventional group (conventional care with foot reflexology) and 40 to control group (conventional care without foot reflexology). Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. RESULTS The severity of acute nausea and vomiting was assessed with a visual analogue scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for control group (20.6%, P = 0.01). Across all cycle, the foot reflexology group showed a trend towards less frequent delayed nausea (P=0.28), a significantly less frequent consumption of antiemetic drugs (P=0.04), and no significant difference for vomiting (P=0.99); there was a trend towards a perception of stronger severity for delayed nausea in the control group (P=0.39). According to quality of life and anxiety, there was no significant difference between the interventional group and the control group (P=0.32 and P=0.53 respectively). CONCLUSIONS In conclusion, the present study results indicated that foot reflexology decreased significantly the severity of acute nausea and consumption of antiemetic drugs in lung and digestive cancer patients. No side effects from foot reflexology have been noted. In order to better respond to a desire of patients for non-pharmacological treatments and CAMs to be used in hospitals to improve their care, the results of this study showed that foot reflexology seems to be a promising complement to conventional antiemetic drugs. To assess the performance of this intervention in routine practice, a larger study with several health care centers would be relevant with a cluster RCT. CLINICALTRIAL The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) INTERNATIONAL REGISTERED REPORT RR2-10.2196/17232

scholarly journals The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Takahisa Handa ◽  
Akinobu Nakamura ◽  
Aika Miya ◽  
Hiroshi Nomoto ◽  
Hiraku Kameda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Multivariate Logistic Regression Analysis ◽  
Glycemic Variability ◽  
Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

scholarly journals Actigraphic Measurement of the Upper Limbs for the Prediction of Ischemic Stroke Prognosis: An Observational Study

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2479
Author(s):  
Giuseppe Reale ◽  
Silvia Giovannini ◽  
Chiara Iacovelli ◽  
Stefano Filippo Castiglia ◽  
Pietro Picerno ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Acute Phase ◽  
Stroke Unit ◽  
Prognostic Model ◽  
Recovery Process ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Movement Asymmetry

Background: It is often challenging to formulate a reliable prognosis for patients with acute ischemic stroke. The most accepted prognostic factors may not be sufficient to predict the recovery process. In this view, describing the evolution of motor deficits over time via sensors might be useful for strengthening the prognostic model. Our aim was to assess whether an actigraphic-based parameter (Asymmetry Rate Index for the 24 h period (AR2_24 h)) obtained in the acute stroke phase could be a predictor of a 90 d prognosis. Methods: In this observational study, we recorded and analyzed the 24 h upper limb movement asymmetry of 20 consecutive patients with acute ischemic stroke during their stay in a stroke unit. We recorded the motor activity of both arms using two programmable actigraphic systems positioned on patients’ wrists. We clinically evaluated the stroke patients by NIHSS in the acute phase and then assessed them across 90 days using the modified Rankin Scale (mRS). Results: We found that the AR2_24 h parameter positively correlates with the 90 d mRS (r = 0.69, p < 0.001). Moreover, we found that an AR2_24 h > 32% predicts a poorer outcome (90 d mRS > 2), with sensitivity = 100% and specificity = 89%. Conclusions: Sensor-based parameters might provide useful information for predicting ischemic stroke prognosis in the acute phase.

scholarly journals Current status of periodontitis and its association with tobacco use amongst adult population of Sunsari district, in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Goel ◽  
S. Sharma ◽  
D. D. Baral ◽  
S. K. Agrawal
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Periodontal Diseases ◽  
Adult Population ◽  
Multivariate Logistic Regression Analysis ◽  
Case Definition ◽  
Current Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Factors

Abstract Background Tobacco products are considered significant, but preventable factors related to initiation and progression of periodontal diseases. We assessed the prevalence of periodontitis and evaluated its association with tobacco use and other factors amongst the adult population of Sunsari district in eastern Nepal. Methods A community-based, cross-sectional study was conducted in rural municipalities in the province one of eastern Nepal. A total of 440 adults were interviewed with a set of a pre-tested semi-structured questionnaire. Data on social demographics, adverse oral habits followed by periodontal clinical examination were recorded. Prevalence of periodontitis was assessed by a case definition provided by CDC-AAP. Univariate and multivariate logistic regression analysis was done to measure the association between tobacco use and other factors with periodontitis. Results The overall prevalence of periodontitis was found to be 71.6%. Majority (85.4%) of tobacco users had periodontitis and they were significantly associated with the disease and its severity. The study identified age groups, 45–65 years (AOR = 7.58, 95% CI 3.93–14.61), plaque accumulation (AOR = 1.01, 95% CI 1.00–1.02), smoking (AOR = 3.14, 95% CI 1.36–7.27), khaini users (smokeless tobacco, AOR = 2.27, 95% CI 1.12–4.61) and teeth loss (AOR = 2.02, 95% CI 1.21–3.38) as the significant factors associated with periodontitis. Conclusion The prevalence of periodontitis is high in the surveyed rural adult population. Cigarette smoking along with the use of smokeless tobacco in the form of khaini were identified as significant factors associated with periodontitis.

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