Current Opinion in Supportive and Palliative Care最新文献_第7页

Virtual oncology research-different models and lessons learned. 虚拟肿瘤学研究的不同模式和经验教训。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 Epub Date: 2022-07-22 DOI: 10.1097/SPC.0000000000000605

P Ranganathan, C S Pramesh

{"title":"Virtual oncology research-different models and lessons learned.","authors":"P Ranganathan, C S Pramesh","doi":"10.1097/SPC.0000000000000605","DOIUrl":"10.1097/SPC.0000000000000605","url":null,"abstract":"Purpose of review: The COVID-19 pandemic posed several challenges to cancer research including halting of trials, reduced recruitment and protocol violations related to inflexible processes followed in clinical trials. Researchers adopted innovative measures to mitigate these problems and continue studies without compromising their quality. This review collates these adaptations that could well continue after the pandemic.Recent findings: The COVID-19 pandemic forced researchers globally to adopt innovative measures to overcome the challenges of the pandemic. These included protocol amendments to adjust to the pandemic and travel restrictions, and increased use of digital technologies. 'Virtual' clinical trials were conducted increasingly with adaptations in ethics and regulatory approvals, patient recruitment and consenting, study interventions and delivery of study medications, trial assessments, and monitoring. Many of these adaptations are safe and feasible, without compromising study quality and data integrity. Although these may not be universally applicable in all types of research, they bring many benefits including more diverse patient participation, less burden on patients for study procedures and reduced resources to conduct trials.Summary: The COVID-19 pandemic has affected cancer research adversely; however, learnings from the pandemic and adaptations from researchers are likely to improve the efficiency of clinical research beyond the pandemic.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451610/pdf/cospa-16-117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40586822","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: 1

Healthcare provider experiences during COVID-19 redeployment. 医疗保健提供商在COVID-19重新部署期间的经验。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 DOI: 10.1097/SPC.0000000000000609

Christian Schulz-Quach, Brendan Lyver, Madeline Li

{"title":"Healthcare provider experiences during COVID-19 redeployment.","authors":"Christian Schulz-Quach, Brendan Lyver, Madeline Li","doi":"10.1097/SPC.0000000000000609","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000609","url":null,"abstract":"Purpose of review: Among the myriad traumatic impacts of COVID-19, the need for redeployment served as a significant stressor for healthcare providers (HCPs). This narrative review summarizes the current literature on HCP redeployment experiences and institutional support for staff, while proposing a theoretical approach to mitigating the negative impact on HCP mental health.Recent findings: Redeployment was a strong predictor of negative emotions in HCP during the initial stage of the COVID-19 pandemic, whereas reflections on benefit-finding associated with redeployment were reported more frequently during later stages. In institutions where attention to redeployment impact was addressed and effective strategies put in place, redeployed HCP felt they received adequate training and support and felt satisfied with the information provided. Redeployment had the potential to yield personal feelings of accomplishment, situational leadership, meaning, and increased sense of team connectedness.Summary: Benefit-finding, or posttraumatic growth, is a concept in cancer psychiatry which speaks to construing benefits from adversity to support resilience. Redeployment experiences can result in unexpected benefit-finding for individual HCPs. Taking a benefit-finding, relational, and existentially informed approach to COVID-19 redeployment might serve as an opportunity for posttraumatic growth for both individuals and institutions.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40586825","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

Nonpharmacological approaches for improving gut resilience to chemotherapy. 提高肠道化疗恢复力的非药物方法。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 Epub Date: 2022-07-15 DOI: 10.1097/SPC.0000000000000599

Brooke M Bullard, Sierra J McDonald, Thomas D Cardaci, Brandon N VanderVeen, E Angela Murphy

{"title":"Nonpharmacological approaches for improving gut resilience to chemotherapy.","authors":"Brooke M Bullard, Sierra J McDonald, Thomas D Cardaci, Brandon N VanderVeen, E Angela Murphy","doi":"10.1097/SPC.0000000000000599","DOIUrl":"10.1097/SPC.0000000000000599","url":null,"abstract":"Purpose of review: Mucositis of the gastrointestinal tract is a debilitating side effect of chemotherapy that negatively influences treatment tolerance and patient life quality. This review will evaluate the recent literature on nonpharmacological strategies that have the potential to improve chemotherapy-induced mucositis (CIM).Recent findings: Alternatives to pharmacological approaches have shown great promise in preventing CIM. Natural products, including curcumin, ginseng, quercetin, and patchouli all show potential in mitigating CIM. In addition, dietary patterns, such as the elemental diet, high fiber diet, and diets high in amino acids have documented benefits in preventing CIM. Perhaps the greatest advancement coming to this arena in recent years is in the field of probiotics. Indeed, research on single species as well as probiotic mixtures show potential in reducing CIM insofar as probiotics are now being suggested for treatment of CIM by governing bodies. Although behavioral interventions including psychological interventions and exercise interventions have shown promise in reducing cancer therapy-related side effects, more work in this domain is warranted and particularly in the context of CIM.Summary: Alternatives to pharmacological approaches show great potential for use in prevention and treatment of CIM and should be further developed for use in the clinic.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40635330","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: 1

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients. 2019冠状病毒病大流行对肿瘤患者支持性和姑息性护理的提供和模式的影响。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 Epub Date: 2022-07-18 DOI: 10.1097/SPC.0000000000000606

Karineh Kazazian, Deanna Ng, Carol J Swallow

{"title":"Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients.","authors":"Karineh Kazazian, Deanna Ng, Carol J Swallow","doi":"10.1097/SPC.0000000000000606","DOIUrl":"10.1097/SPC.0000000000000606","url":null,"abstract":"Purpose of review: Supportive and palliative care services have been an important component of the overall COVID-19 pandemic response. However, significant changes in the provision and models of care were needed in order to optimize the care delivered to vulnerable cancer patients. This review discusses the evolution of palliative and supportive care service in response to the pandemic, and highlights remaining challenges.Recent findings: Direct competition for resources, as well as widespread implementation of safety measures resulted in major shifts in the mode of assessment and communication with cancer patients by supportive care teams. Telemedicine/virtual consultation and follow-up visits became an integral strategy, with high uptake and satisfaction amongst patients, families and providers. However, inequities in access to the required technologies were sometimes exposed. Hospice/palliative care unit (PCU) bed occupancy declined markedly because of restrictive visitation policies. Collection of patient-reported outcome (PRO) data was suspended in many cancer centers, with resulting under-recognition of anxiety and depression in ambulatory patients. As in many other areas, disparities in delivery of supportive and palliative care were magnified by the pandemic.Summary: Virtual care platforms have been widely adopted and will continue to be used to include a wider circle of family/friends and care providers in the provision of palliative and supportive care. To facilitate equitable delivery of supportive care within a pandemic, further research and resources are needed to train and support generalists and palliative care providers. Strategies to successfully collect PROs from all patients in a virtual manner must be developed and implemented.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451606/pdf/cospa-16-130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40526244","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: 3

Editorial introductions. 编辑介绍。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 DOI: 10.1097/SPC.0000000000000612

引用次数: 0

Effects of coronavirus disease 19 on the gastrointestinal tract and the potential impact on gastrointestinal toxicities during cancer treatment. 冠状病毒19对胃肠道的影响及癌症治疗期间对胃肠道毒性的潜在影响

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-09-01 DOI: 10.1097/SPC.0000000000000604

Andrea M Stringer

{"title":"Effects of coronavirus disease 19 on the gastrointestinal tract and the potential impact on gastrointestinal toxicities during cancer treatment.","authors":"Andrea M Stringer","doi":"10.1097/SPC.0000000000000604","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000604","url":null,"abstract":"Purpose of review: Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has resulted in a global pandemic, with people with other conditions at greater risk of severe infection with intensified symptoms across multiple organ systems. Patients with cancer are at greater risk, and it is likely that those receiving treatment will experience greater incidence and severity of gastrointestinal toxicities, such as gastrointestinal mucositis, due to SARS-CoV-2 binding to angiotensin-converting enzyme (ACE)2 in the intestine.Recent findings: Recent studies have shown that SARS-CoV-2 patients experience gastrointestinal toxicities, and SARS-CoV-2 has capacity to infect intestinal cells through binding to ACE2 expressed in the intestine. ACE2 has a key role in intestinal homeostasis, and as such there is a concern for the impact of SARS-CoV-2 binding to ACE2 in terms of the implications for cancer treatment-induced gastrointestinal toxicities.Summary: SARS-CoV-2 is a high-risk infection for cancer patients receiving treatment. It is important to understand the mechanisms of intestinal infection with SARS-CoV-2 to determine the effect of SARS-CoV-2 infections on gastrointestinal toxicities, such as mucositis.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40585773","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

Editorial introductions. 编辑介绍。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-06-01 DOI: 10.1097/SPC.0000000000000596

引用次数: 0

New analgesics in cancer pain 癌症疼痛的新型镇痛药

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-06-01 DOI: 10.1097/SPC.0000000000000592

E. Farrer, A. Dickman

引用次数: 0

The pain conductor: brainstem modulation in acute and chronic pain. 疼痛传导器：急性和慢性疼痛的脑干调节。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-06-01 DOI: 10.1097/SPC.0000000000000598

Lewis S Crawford, Damien C Boorman, Kevin A Keay, Luke A Henderson

{"title":"The pain conductor: brainstem modulation in acute and chronic pain.","authors":"Lewis S Crawford, Damien C Boorman, Kevin A Keay, Luke A Henderson","doi":"10.1097/SPC.0000000000000598","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000598","url":null,"abstract":"Purpose of review: It is well established in experimental settings that brainstem circuits powerfully modulate the multidimensional experience of pain. This review summarizes current understanding of the roles of brainstem nuclei in modulating the intensity of pain, and how these circuits might be recruited therapeutically for pain relief in chronic and palliative settings.Recent findings: The development of ultra-high field magnetic resonance imaging and more robust statistical analyses has led to a more integrated understanding of brainstem function during pain. It is clear that a number of brainstem nuclei and their overlapping pathways are recruited to either enhance or inhibit incoming nociceptive signals. This review reflects on early preclinical research, which identified in detail brainstem analgesic function, putting into context contemporary investigations in humans that have identified the role of specific brainstem circuits in modulating pain, their contribution to pain chronicity, and even the alleviation of palliative comorbidities.Summary: The brainstem is an integral component of the circuitry underpinning pain perception. Enhanced understanding of its circuitry in experimental studies in humans has, in recent years, increased the possibility for better optimized pain-relief strategies and the identification of vulnerabilities to postsurgical pain problems. When integrated into the clinical landscape, these experimental findings of brainstem modulation of pain signalling have the potential to contribute to the optimization of pain management and patient care from acute, to chronic, to palliative states.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161097","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

Noninvasive respiratory supports for the relief of terminal breathlessness 无创呼吸支持缓解终末期呼吸困难

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2022-06-01 DOI: 10.1097/SPC.0000000000000593

J. Inglis, C. Furst, Linda M Foreman

{"title":"Noninvasive respiratory supports for the relief of terminal breathlessness","authors":"J. Inglis, C. Furst, Linda M Foreman","doi":"10.1097/SPC.0000000000000593","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000593","url":null,"abstract":"Purpose of review Breathlessness is a common symptom in patients with respiratory failure in the terminal phase of their illness. Noninvasive methods of oxygen delivery are frequently used in the palliative setting. We review the evidence supporting noninvasive respiratory supports for the relief of terminal breathlessness in those with life-limiting illnesses. Recent findings There is limited evidence to support the use of supplemental oxygen for patients without hypoxia. It is unclear whether the symptomatic benefit of oxygen therapy relates to the oxygen delivery and/or airflow across the nasal mucosa. Early trials suggest that high-flow nasal cannula (HFNC) oxygen therapy improves breathlessness at rest and on exertion for patients with cancer. Noninvasive ventilation (NIV) also appears to improve breathlessness in the palliative setting; however, potential harms include facial pressure injuries, claustrophobia and anxiety. Goals of care should be explicitly discussed and frequently reviewed given that these interventions have the potential for harm and can be challenging to withdraw. Summary HFNC oxygen therapy and NIV appear to reduce breathlessness in the palliative setting. Further high-quality trials are needed to confirm the symptomatic benefits of noninvasive respiratory supports on breathlessness for patients with cancer.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44930161","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: 2