Current Opinion in Supportive and Palliative Care最新文献_第5页

Exercise interventions for frail older adults with cancer. 对患有癌症的体弱老年人进行运动干预。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-06 DOI: 10.1097/spc.0000000000000685

Schroder Sattar, Kristen R Haase, Kayoung Lee, Kristin L Campbell

引用次数: 0

Mechanisms inherent in acute-to-chronic pain after surgery - risk, diagnostic, predictive, and prognostic factors. 手术后急性到慢性疼痛的内在机制——风险、诊断、预测和预后因素。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-09-08 DOI: 10.1097/SPC.0000000000000673

Daniela C Rosenberger, Daniel Segelcke, Esther M Pogatzki-Zahn

{"title":"Mechanisms inherent in acute-to-chronic pain after surgery - risk, diagnostic, predictive, and prognostic factors.","authors":"Daniela C Rosenberger, Daniel Segelcke, Esther M Pogatzki-Zahn","doi":"10.1097/SPC.0000000000000673","DOIUrl":"10.1097/SPC.0000000000000673","url":null,"abstract":"Purpose of review: Pain is an expected consequence of a surgery, but it is far from being well controlled. One major complication of acute pain is its risk of persistency beyond healing. This so-called chronic post-surgical pain (CPSP) is defined as new or increased pain due to surgery that lasts for at least 3 months after surgery. CPSP is frequent, underlies a complex bio-psycho-social process and constitutes an important socioeconomic challenge with significant impact on patients' quality of life. Its importance has been recognized by its inclusion in the eleventh version of the ICD (International Classification of Diseases).Recent findings: Evidence for most pharmacological and non-pharmacological interventions preventing CPSP is inconsistent. Identification of associated patient-related factors, such as psychosocial aspects, comorbidities, surgical factors, pain trajectories, or biomarkers may allow stratification and selection of treatment options based on underlying individual mechanisms. Consequently, the identification of patients at risk and implementation of individually tailored, preventive, multimodal treatment to reduce the risk of transition from acute to chronic pain is facilitated.Summary: This review will give an update on current knowledge on mechanism-based risk, prognostic and predictive factors for CPSP in adults, and preventive and therapeutic approaches, and how to use them for patient stratification in the future.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Should opioids be used for breathlessness and in whom? A PRO and CON debate of the evidence. 阿片类药物应该用于治疗呼吸困难吗?用于治疗谁?证据的正反辩论。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-10-26 DOI: 10.1097/SPC.0000000000000674

Magnus Ekström, Daisy J A Janssen

{"title":"Should opioids be used for breathlessness and in whom? A PRO and CON debate of the evidence.","authors":"Magnus Ekström, Daisy J A Janssen","doi":"10.1097/SPC.0000000000000674","DOIUrl":"10.1097/SPC.0000000000000674","url":null,"abstract":"Purpose of review The net clinical benefit of opioids for chronic breathlessness has been challenged by recent randomized clinical trials. The purpose was to review and weigh the evidence for and against opioid treatment for chronic breathlessness in people with serious disease. Recent findings Evidence to date on the efficacy and safety of opioids for chronic breathlessness was reviewed. Findings supporting a benefit from opioids in meta-analyses of earlier, mostly smaller trials were not confirmed by recent larger trials. Evidence pertains mostly to people with chronic obstructive pulmonary disease but also to people with pulmonary fibrosis, heart failure, and advanced cancer. Taken together, there is no consistent evidence to generally recommend opioids for severe breathlessness or to identify people who are more likely to benefit. Opioid treatment may be tested in patients with intractable breathlessness and limited other treatment options, such as in end-of-life care. Knowledge gaps were identified and recommendations were made for future research. Summary Key Points Supportive findings of net benefit of opioids for chronic breathlessness in earlier trials have not been confirmed by recent larger randomized clinical trials. There is no evidence that the opioid treatment improves the person’s exercise capacity or quality of life, and it increases the risk of adverse events. Evidence to date does not support that opioids should generally be recommended for treating breathlessness. In people with intractable symptoms and short expected survival, with few or no treatment options, it may still be reasonable to try opioid treatment with the aim to alleviate severe breathlessness. Research is needed to explore the potential benefit of opioids in selected patient groups. Opioids cannot be generally recommended for treating breathlessness based on insufficient evidence for net clinical benefit.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiation therapy options in kidney cancer. 肾癌的放射治疗选择。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-10-26 DOI: 10.1097/SPC.0000000000000683

Nicholas G Zaorsky, Alexander V Louie, Shankar Siva

引用次数: 0

The role of corticosteroids in the palliation of dyspnea in cancer patients: an evidence-based review. 皮质类固醇在缓解癌症患者呼吸困难中的作用：循证综述。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-09-29 DOI: 10.1097/SPC.0000000000000677

David Hui, Sriram Yennurajalingam

{"title":"The role of corticosteroids in the palliation of dyspnea in cancer patients: an evidence-based review.","authors":"David Hui, Sriram Yennurajalingam","doi":"10.1097/SPC.0000000000000677","DOIUrl":"10.1097/SPC.0000000000000677","url":null,"abstract":"Purpose of review: To provide an evidence-based review on the use of corticosteroids for dyspnea in cancer patients.Recent findings: Corticosteroids are commonly used for palliation of dyspnea; however, there is wide variation in how they are prescribed due to the paucity of high-quality evidence. Some clinicians would offer corticosteroids routinely regardless of the causes of dyspnea, while others would only prescribe corticosteroids selectively for specific indications, such as lymphangitic carcinomatosis, upper airway obstruction, superior vena cava obstruction, and cancer treatment-induced pneumonitis. Few mechanistic studies have been conducted to support the use of corticosteroids in cancer patients. Two double-blind, placebo-controlled randomized trials have examined the routine use of high-dose dexamethasone for dyspnea in cancer patients. A pilot study suggested some benefits, but the larger confirmatory trial revealed no improvement compared to the placebo and significantly more adverse events. The selective use of corticosteroids use is only based on observational studies such as case series.Summary: The unfavorable risk:benefit ratio of high-dose dexamethasone suggests that it should not be routinely prescribed for dyspnea in cancer patients. More research is needed to assess the selective use of corticosteroids and identify patients most likely be benefit from corticosteroid use.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative systemic therapy in renal cell carcinoma. 肾细胞癌的围手术期全身治疗。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-10-06 DOI: 10.1097/SPC.0000000000000675

Ceilidh MacPhail, Lori A Wood, Myuran Thana

引用次数: 0

Treatment of primary cancer in metastatic hormone-sensitive prostate cancer. 转移性激素敏感性前列腺癌症原发性癌症的治疗。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-10-03 DOI: 10.1097/SPC.0000000000000676

Kylie Y-Y Lim, Matthew Alberto, Weranja Ranasinghe

引用次数: 0

Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases. 慢性呼吸系统疾病患者的焦虑和创伤后应激障碍

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-08-10 DOI: 10.1097/SPC.0000000000000670

Abebaw M Yohannes

{"title":"Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases.","authors":"Abebaw M Yohannes","doi":"10.1097/SPC.0000000000000670","DOIUrl":"10.1097/SPC.0000000000000670","url":null,"abstract":"Purpose of review: This brief critical review evaluates recent research on the impact of anxiety disorders and post-traumatic stress disorders (PTSD) on patients with chronic obstructive pulmonary disease (COPD) and asthma. In these patients, untreated anxiety and PTSD exacerbate acute symptoms, increase disability and impair quality of life. Therefore, effective interventions are also reviewed.Recent findings: Anxiety disorders and PTSD are prevalent in COPD and asthma, worsen symptoms in acute exacerbations, and increase morbidity and healthcare utilization. Pulmonary rehabilitation (PR), cognitive behavioural therapy and pharmacological therapy are each effective in COPD patients with anxiety or PTSD. However, very little work examined therapy for combined anxiety and PTSD in patients with either COPD or asthma.Summary: Despite the high prevalence of anxiety disorder or PTSD in patients with chronic respiratory diseases, a paucity of literature remains demonstrating the efficacy of pharmacological therapies for these conditions. This review highlights the promising benefits of PR on anxiety, but prospective trials are needed to demonstrate the efficacy of interventions with PTSD alone, or with concomitant anxiety.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Goals of care and end-of-life communication needs of persons with chronic respiratory disease. 慢性呼吸道疾病患者的护理和临终沟通需求目标。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-09-04 DOI: 10.1097/SPC.0000000000000672

Lynn F Reinke, Tracy Fasolino, Donald R Sullivan

{"title":"Goals of care and end-of-life communication needs of persons with chronic respiratory disease.","authors":"Lynn F Reinke, Tracy Fasolino, Donald R Sullivan","doi":"10.1097/SPC.0000000000000672","DOIUrl":"10.1097/SPC.0000000000000672","url":null,"abstract":"Purpose of the review: To highlight recent advances in effective communication among persons with chronic respiratory diseases. The authors focus on communication science related to goals of care (GOC) discussions, medical devices, and life-sustaining invasive treatments. The authors discuss important considerations when working with individuals with low literacy and rurality. Communication handoffs between respiratory clinicians and/or palliative care to hospice clinicians are summarized to ensure effective person-centered and caregiver-centered care.Recent findings: Studies suggest the following communication approaches: (1) clarify differences between palliative and end of life; (2) conduct conversations early and gradual throughout the illness trajectory; (3) distinguish types of GOC discussions as they relate to treatment preferences; (4) for patients from rural communities, include family members and spiritual leaders; (5) assess literacy and employ supportive strategies; (6) apply time-limited-trial framework for life-sustaining treatment (LST) decisions; and (7) standardize processes for communication handoffs to hospice clinicians to improve communication fidelity.Summary: Effective communication tools for clinicians to engage in GOC discussions for persons with chronic respiratory diseases are grounded in a patient-centered framework. A trained clinician should lead these conversations and include interdisciplinary team members throughout the disease trajectory including at the end of life. These approaches may enable patients to express their values and care preferences as they evolve over time.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tackling respiratory problems - needs, education, and treatments. 解决呼吸问题——需求、教育和治疗。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-01 Epub Date: 2023-10-26 DOI: 10.1097/SPC.0000000000000679

Magnus Ekström, Daisy J A Janssen

引用次数: 0