Annals of palliative medicine最新文献

{"title":"The role of the radiation oncologist in hospice decision-making and early discontinuation of palliative radiation therapy.","authors":"Joy Ogunmuyiwa, Divya Yerramilli","doi":"10.21037/apm-25-47","DOIUrl":"https://doi.org/10.21037/apm-25-47","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032571","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}

{"title":"Delirium derived from dementia with Lewy bodies in the cancer perioperative period: a case report.","authors":"Junji Yamaguchi, Ryoichi Sadahiro, Saho Wada, Eri Nishikawa, Tatsuto Terada, Rika Nakahara, Hiromichi Matsuoka","doi":"10.21037/apm-25-48","DOIUrl":"https://doi.org/10.21037/apm-25-48","url":null,"abstract":"<p><strong>Background: </strong>Delirium derived from dementia with Lewy bodies (DLB), and the risk of drug hypersensitivity derived from DLB is not well recognized in oncology. To avoid severe side effects caused by antipsychotics, these risks need to be carefully considered by health care providers involved in cancer treatment. The objective of this study is to report the presence of DLB-derived delirium, which is often mixed with ordinary delirium, and its associated hidden risk in cancer treatment.</p><p><strong>Case description: </strong>A male in his 80s presented with no history of psychiatric disorders. Although he had experienced visual hallucinations such as animals or persons, and the gradual progression of Parkinsonism for several years, he was not undergoing treatment by a psychiatrist. When hospitalized for endoscopy examination, he became agitated with delusions and hallucinations, and was diagnosed with delirium. The examination was postponed. After 2 months, he was diagnosed with DLB, and the delirium he experienced was regarded as a part of DLB. After treatment with donepezil, lemborexant, and yokukansan (a Japanese herbal medicine), his mental status stabilized, and the surgery was conducted safely after drug hypersensitivity with DLB was carefully considered.</p><p><strong>Conclusions: </strong>In the cancer perioperative period, delirium derived from DLB may occur mixed with ordinary delirium. Oncologists need to be aware of the risk of hidden DLB with delirium and remain updated regarding this topic. In addition, these patients may well be treated with psychotropics that, in principle, do not exacerbate extrapyramidal symptoms, such as donepezil, yokukansan, and lemborexant.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032589","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}

{"title":"A clinical practice review: management strategies and emerging approaches for anastomotic leakage following radical surgery for esophageal cancer.","authors":"Suchandrima Dutta, Sophie Chen, Xingyu He, Boyu Wang, Zhichao Wu, Waqas Ahmad, Wei Huang, Wa Du, Yanbo Fan, Jialiang Liang, Yigang Wang","doi":"10.21037/apm-25-29","DOIUrl":"https://doi.org/10.21037/apm-25-29","url":null,"abstract":"<p><p>Radical esophagectomy remains the cornerstone of curative treatment for esophageal cancer, but is frequently complicated by postoperative events, most notably anastomotic leakage. Anastomotic leakage, occurring in up to 30% of cases, is multifactorial in origin and significantly increases morbidity and mortality. This review aims to summarize current management strategies, highlight emerging therapies, and identify persistent clinical challenges related to this complication. Relevant studies were identified through targeted literature searches of articles focusing on clinical management, therapeutic innovation, and reported outcomes related to anastomotic leakage, with an emphasis on recent and high-impact publications. This review synthesizes current strategies for the detection, prevention, and management of anastomotic leakage and evaluates emerging interventions. Early diagnosis through contrast-enhanced computed tomography (CT) and esophagography is critical for improving outcomes. Conservative measures such as broad-spectrum antibiotics, nutritional support, and image-guided drainage remain the first-line approach, while surgical revision and endoscopic techniques like stenting and vacuum therapy are increasingly employed in complex cases. Novel therapies, including tissue-engineered constructs and biodegradable stents, are under development but lack large-scale clinical validation. Despite these advancements, major clinical challenges persist, including limited predictive tools for risk stratification, variability in treatment algorithms across institutions, and unclear long-term efficacy of newer interventions. Furthermore, most novel strategies are supported by small cohort studies or preclinical data, limiting their immediate clinical application. Therefore, improved multidisciplinary collaboration, standardized treatment protocols, and integration of predictive diagnostics are essential for optimizing outcomes. Future research should focus on validating emerging therapies through randomized clinical trials and developing personalized management algorithms based on patient-specific risk factors and leak characteristics.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032600","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}

{"title":"Not everything is delirium at the end of life: a case report.","authors":"Daniel Gilbey, Eduardo Bruera, Patricia S Bramati","doi":"10.21037/apm-25-37","DOIUrl":"https://doi.org/10.21037/apm-25-37","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common condition at the end of life and causes significant distress in patients and their loved ones. A precipitant factor can be found in less than half of the patients and the management interventions are limited.</p><p><strong>Case description: </strong>A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation. He appeared to become delirious and agitated, trying to remove the face mask, wriggling in bed, and tapping the bedrails. Haloperidol and lorazepam were required when non pharmacological interventions failed to calm him down. The following morning, the patient was able to explain that the positive-pressure facemask was suffocating him and that he could not breathe. So, he was transitioned to high-flow oxygen via nasal cannula, and within a few hours, his respiratory distress significantly improved, and he regained his previous self.</p><p><strong>Conclusions: </strong>In this report, we highlight the challenges faced by clinical teams diagnosing and managing delirium, in particular when a language barrier is present. Non-invasive bilevel ventilation is generally avoided in patients at the end of life (unless it offers comfort and it is aligned with the patient's wishes), but if used should be considered as a cause of agitation and worsening shortness of breath, especially when it can be easily tested by removing the facemask.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032565","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}

{"title":"Is every pancreatic cancer patient a palliative care patient?","authors":"Nishitha Reddy, Khaldoun Almhanna, Jacob Ramos, Dana Guyer","doi":"10.21037/apm-22-1457","DOIUrl":"https://doi.org/10.21037/apm-22-1457","url":null,"abstract":"<p><p>ancreatic cancer is an aggressive disease and often presents at an advanced stage with no curative options. The disease is often characterized by rapid progression, limited or short-lived responsiveness to standard therapies, and a profound impact on patients' quality of life. Despite advances in targeted therapies and immunotherapy, curative outcomes remain elusive for the majority of patients with advanced or high-grade disease with a 5-year survival rate of less than 10%. Treatment goals must evolve beyond prolonging survival to include alleviating suffering, optimizing function, and preserving dignity. This is where palliative care assumes a vital and indispensable role. Even patients who initially present with resectable disease are at a high risk of recurrence in the future. Pancreatic cancer carries a high symptomatic burden from pain, poor nutrition, malabsorption, jaundice, fatigue as well as depression. Given the overall poor prognosis, early integration of palliative care is essential to address the physical, emotional and spiritual needs of patients and provide patients and families guidance in complex decision-making. Early palliative care involvement has proven time and time again to improve symptoms control, reduce hospitalization and may even improve survival. Palliative care should be provided concurrently with active treatment before becoming the main focus of care for patients with advanced stages of disease.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032618","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}

{"title":"The intersection of ethics, psychiatry, and palliative medicine-reflections on a complex relationship.","authors":"Jan Gaertner, Manuel Trachsel","doi":"10.21037/apm-25-74","DOIUrl":"https://doi.org/10.21037/apm-25-74","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032568","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}

{"title":"Erratum: Palliative care for elderly patients with advanced lung disease.","authors":"","doi":"10.21037/apm-25-55","DOIUrl":"https://doi.org/10.21037/apm-25-55","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 4","pages":"422"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793285","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}

{"title":"Role of rehabilitation in palliative care after the COVID-19 pandemic: a narrative review.","authors":"Christopher M Wilson, Lori E Boright, Ann M Henshaw, Alicia Naccarato","doi":"10.21037/apm-25-6","DOIUrl":"https://doi.org/10.21037/apm-25-6","url":null,"abstract":"<p><strong>Background and objective: </strong>The coronavirus disease 2019 (COVID-19) pandemic resulted in an historic disruption and transformation of the healthcare system, including the management of individuals with serious illness. Rehabilitation for patients facing serious or life-threatening illness is underutilized and poorly understood, resulting in unwarranted suffering, disability, and poorly coordinated care. This narrative review aims to describe the impact of the COVID-19 pandemic on the role and scope of rehabilitation within the context of serious illness and palliative care.</p><p><strong>Methods: </strong>A focused review of the literature included selected articles identified from three databases published from January 2020 to January 2025. Findings were synthesized narratively, with a focus on identifying themes and gaps in the literature related to two main topics: (I) the evidence related to rehabilitation for those with serious or life-threatening COVID-19 during the pandemic and (II) how rehabilitation for patients with serious illness has been transformed after emerging from the pandemic (including non-COVID diagnoses such as cancer, neurologic conditions, etc.).</p><p><strong>Key content and findings: </strong>The key themes identified during the COVID-19 pandemic emphasized the need for early rehabilitation, interdisciplinary care, and an emphasis on cardiopulmonary principles for rehabilitation. Themes identified during the pandemic also included the emerging role of telerehabilitation, and need for evidence and clinical guidelines for serious illnesses (including long COVID). Themes related to the transformative effect on palliative rehabilitation after the pandemic included an increased importance and focus on coordination of care and interdisciplinary care for those with serious illness and increased focus on mental health and social determinants of health (SDOH). Additionally, there appears to be increased infrastructure and activity related to research, advocacy, and awareness for palliative rehabilitation.</p><p><strong>Conclusions: </strong>The COVID-19 global pandemic highlighted the need for high quality, coordinated palliative care, including rehabilitation services, for patients facing a serious or life-threatening illness. Due to the benefits to a person's quality of life (QoL), dignity, and comfort, there is increasing evidence of the importance of seamless, ongoing access to rehabilitation services for patients with serious illness.</p>","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 4","pages":"379-392"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793214","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}

{"title":"Difficulties in diagnosis and treatment-consequences for palliative psychiatry.","authors":"Michael Brinkers, Giselher Pfau, Moritz Kretzschmar","doi":"10.21037/apm-25-36","DOIUrl":"https://doi.org/10.21037/apm-25-36","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 4","pages":"412-414"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793284","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}

{"title":"How do we advance from daily struggles in malignant airway complications?","authors":"Hiroki Matsumoto, Yuichi Sakairi, Taisuke Kaiho, Terunaga Inage, Takamasa Ito, Kazuhisa Tanaka, Ichiro Yoshino, Hidemi Suzuki","doi":"10.21037/apm-25-52","DOIUrl":"https://doi.org/10.21037/apm-25-52","url":null,"abstract":"","PeriodicalId":7956,"journal":{"name":"Annals of palliative medicine","volume":"14 4","pages":"415-416"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793286","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}