Journal of palliative care & medicine最新文献

{"title":"Clinical Impact of the AKT1 rs1130233 SNP in Japanese GastrointestinalCancer Patients with Palliative Care","authors":"T. Morishita, A. Hishida, Y. Okugawa, Y. Morimoto, Y. Shirai, Kyoko Okamoto, Aki Ogawa, Koji Tanaka, R. Nishikawa, Y. Toiyama, Y. Inoue, H. Sakurai, H. Urata, Motoyoshi Tanaka, C. Miki","doi":"10.4172/2165-7386.1000307","DOIUrl":"https://doi.org/10.4172/2165-7386.1000307","url":null,"abstract":"Objective: Cancer patients often suffer from chronic inflammation, anorexia and the resultant decrease of nutrient intake, followed by weight loss and muscle wasting called “sarcopenia”. Such conditions are known as “cachexia”. In this study, we examined the associations between genetic polymorphisms of AKT1 rs1130233, ICAM1 rs281432, SELP rs6128 and TNSRSF1A rs4149570, which are reportedly associated with cachexia in Caucasians, together with LIF rs929271, in Japanese gastrointestinal cancer patients with palliative care. Methods: The study subjects were 59 patients (37 males and 22 females) with gastrointestinal cancers who visited the outpatient clinic at Iga General Hospital from December 2011 till August 2015. Genotypings for AKT1 rs1130233, ICAM1 rs281432, SELP rs6128, TNSRSF1A rs4149570 and LIF rs929271 were conducted with polymerase chain reaction with confronting two-pair primers (PCR-CTPP) or the Taqman SNP Genotyping assay. Associations of these SNPs with patients’ prognosis as well as weight loss defined as weight loss more than 5 percent during 6 months after the initiation of chemotherapy were evaluated. Results: A significant increase in the risk of 5% weight loss was observed in those with A/G genotype AKT1 rs1130233 polymorphism (AKT1 A/G vs. G/G, adjusted odds ratio [aOR]=7.11; 95%CI: 1.41-35.7), or in those with at least one A allele of AKT1 rs1130233 (AKT1 A/G+A/A vs. G/G, aOR=4.57; 95% CI: 1.14-18.3) when adjusted for age, sex and UICC clinical stage 4. There was no statistically significant correlation of the polymorphisms examined with patients’ survival. Conclusion: The present study revealed that AKT1 rs1130233 A allele may play a key role in the development of cancer cachexia. Given the involvement of AKT1 in the development of cancer as well as in apoptosis, it would be worth studying the roles of this molecule in human cancers further from clinical, epidemiological and biological viewpoints in the near future.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44754237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANALYZING THE MOVIE MY LIFE UNDER THE PERSPECTIVE OF THE KÜBLER-ROSS","authors":"M. Bottini, Mariana Souza","doi":"10.4172/2165-7386-C1-009","DOIUrl":"https://doi.org/10.4172/2165-7386-C1-009","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70691058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE INTERSECTIONALITY OF TRAUMA AND GRIEF: THE GIFTS OF EMDR","authors":"C. Kennedy","doi":"10.4172/2165-7386-C1-007","DOIUrl":"https://doi.org/10.4172/2165-7386-C1-007","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70691121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality at a Portuguese Internal Medicine Service: Is Patient Allocation aDeterminant Factor?","authors":"Luciana Sousa, Ana Rita Marques, Inês Burmester, I. Apolinário, I. Br, Ao","doi":"10.4172/2165-7386.1000306","DOIUrl":"https://doi.org/10.4172/2165-7386.1000306","url":null,"abstract":"Objectives: To verify if patient’s allocation by different wards is a determinant factor of mortality risk. \u0000Design: Retrospective longitudinal study, using individual patient data from Internal Medicine Service in Hospital \u0000 de Braga, Portugal. \u0000Setting: From 1st to 31th January 2015. \u0000Participants were eligible to our study all patients admitted do Internal Medical care, who hadn’t been transferred \u0000 from different specialty’s wards during hospitalization or remained at Intermediate Care Unit in Emergency Room \u0000 more than 24 hours. \u0000Main outcome measures: Patients admitted to Internal Medicine’s wards and those admitted on other specialty’s \u0000 wards, were compared for all-cause mortality, 2nd day mortality means and time to death. Analyses using t-student \u0000 test and χ2 test (SPSS Statistics 22.0). \u0000Results: A total of 319 patients were included in our study, 49.5% (158) were admitted to our medical wards and \u0000 50.5% (161) were admitted to a different specialty ward. There were respectively 16.5% (26) and 18.6% (30) total \u0000 deaths and 3.8% (1) and 23.3% (7) 2nd day mortality. We also find that Internal Medicine ward time to death was \u0000 12.0 days and other inpatient ward time to death was 6.13 days. There was no statistically significant difference \u0000 between groups for all-cause mortality (t(317)=-0.510; p=0.611; d=0.07), but for 2nd day mortality and time to death \u0000 we found a statistic significant difference (t(44)=2.11; p=0.04; d=-0.56) and (t(37.2)=3.32; p-value=0.002; d=0.92) \u0000 respectively. \u0000Conclusions: The present study highlight “patient allocation” as a determinant factor for early mortality risk. \u0000 Further research is needed to understand which morbidity and mortality factors are associated with these findings.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42401689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care Gains Roots in China","authors":"L. Tang, M. Silbermann","doi":"10.4172/2165-7386.1000E140","DOIUrl":"https://doi.org/10.4172/2165-7386.1000E140","url":null,"abstract":"In China over the past decade, palliative medicine has emerged as a new program. Development of this program \u0000 requires attention to current opportunities, obstacles and cultural concerns. A selected review showed that there is \u0000 an urgent need for palliative care in mainland China. Several challenges to implementing palliative care service in \u0000 China include: (1) cultural perception and misunderstanding of palliative care; (2) lack of professionally trained \u0000 health-care providers; (3) administrative and policy problems; and (4) limited funding for palliative care and research. \u0000 More efforts should be made in clinical practice, education and research to develop and implement palliative care in \u0000 mainland China.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"7 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000E140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42346488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-assessment and Screening for Palliative Care Need in Patients with ChronicHeart Failure","authors":"K. Oechsle, J. Ehlert, Y. Kodolitsch, A. Ullrich, C. Bokemeyer, M. Rybczynski","doi":"10.4172/2165-7386.1000304","DOIUrl":"https://doi.org/10.4172/2165-7386.1000304","url":null,"abstract":"Objective: Patients with chronic heart failure (CHF) rarely receive palliative care today. \u0000Methods: In a cross-sectional pilot study we evaluated feasibility of self-assessment and physician-directed \u0000 screening for palliative care need in CHF patients. Patients answered German versions of the “Minimal \u0000 Documentation system for patients in palliative care” (MIDOS), “Distress-Thermometer” (DT), and the “Patient \u0000 Health Questionnaire” (PHQ4). A modified version of the “Five-Item Palliative Care Screening Tool” was used to \u0000 screen for palliative care need by the treating cardiologists. \u0000Results: 218 patients were asked to participate and 148 (67%) completed all questionnaires. Median symptom \u0000 burden (MIDOS) was 7 out of 30 points (SD 4.868), overall wellbeing was two of 5 (SD 0.902), and median distress \u0000 score was 6 of 10 (SD 2.318). Most frequent moderate or severe symptoms were dyspnea (52%), weakness (51%), \u0000 and tiredness (49%). Significant distress (DT score>5) was indicated by 106 patients (72%). Exhaustion (79%), \u0000 sleeping problems (75%), and problems with breathing (69%) were most frequent problems. Only 11% and 14% of \u0000 patients presented with significant anxiety and depression, respectively (PHQ4-score>3). \u0000Palliative care need was scored with mean 6.8 out of 12 points (SD 2.223). Using a cut-off value of >5, 113 \u0000 patients (76%) would have needed palliative care. Objective parameters for palliative care need (symptom burden \u0000 43%, distress 68%, decision-making 67%) were indicated, but request for palliative care by the patients, their \u0000 relatives (5%) or the cardiology team (5%) was rare. Symptom burden and palliative care screening showed \u0000 significant, but not clinically relevant interaction. \u0000Conclusion: This pilot study, feasibility of palliative care self-assessment and the modified screening instrument \u0000 could be demonstrated in CHF patients. For comprehensive screening, both perspectives have to be included. First \u0000 results indicate significant symptom burden, psychological distress and a high need for additional palliative care in \u0000 CHF patients.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43496231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facing Death Mindfully","authors":"P. Dobkin","doi":"10.4172/2165-7386.1000303","DOIUrl":"https://doi.org/10.4172/2165-7386.1000303","url":null,"abstract":"One Sunday night, well past midnight, while my body was motionless and my mind roamed, Naomi summoned me. I felt the urgency of her plea in the crux of my being. I sensed that Naomi was slipping into a quandary. Where was she? Her cries were loon-like. I blindly cast a lifeline into dark waters. It sank. Waves, like breath, moved in and out as they met the shore. The smell of pines permeated the nocturnal air. My heart beat startled me into wakefulness. The time had come.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48283289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided Phrenic Nerve Block for Intractable Hiccups in Patients withMetastatic Colon Cancer: A Case Report","authors":"Tiffani Pittman, Andra DiStephano, R. Chow, Ron E. Samet","doi":"10.4172/2165-7386.1000302","DOIUrl":"https://doi.org/10.4172/2165-7386.1000302","url":null,"abstract":"Intractable hiccups can be a debilitating condition in cancer patients especially for those who have recently undergone thoracic or abdominal surgery and have tumor loads causing diaphragmatic irritation. The following case report details complete resolution of severe intractable hiccups due to an ultrasound guided phrenic nerve block in a patient with unresectable metastatic colon cancer. Ultrasound guided phrenic nerve block modification of the commonly performed interscalene brachial plexus may prove beneficial in relieving hiccups when medication therapy has failed or causes untoward side effects.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43059766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care in Rural India: Lessons from Hemalkasa","authors":"Anirudh Ramesh","doi":"10.4172/2165-7386.1000301","DOIUrl":"https://doi.org/10.4172/2165-7386.1000301","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46958009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Palliative Curative Treatment of Untreatable Metastatic Solid Tumor Patients by a Psycho-Neuroendocrino-Immunophytotherapic (PNEIF) Regimen with Natural Anticancer Agents","authors":"P. Lissoni, G. Messina, F. Brivio, F. Rovelli, L. Fumagalli, G. Fede","doi":"10.4172/2165-7386.1000299","DOIUrl":"https://doi.org/10.4172/2165-7386.1000299","url":null,"abstract":"Several natural agents, including both human endogenous neuroendocrine substances, namely the pineal hormones, and plants, mainly Aloe, Myrrh and Magnolia, have been proven to exert anticancer activities, due to antiproliferative and immunomodulating properties. On this basis, a study was planned in an attempt to evaluate the therapeutic efficacy of a psychoneuroendocrinoimmun-phytotherapic (PNEIF) regimen with pineal hormones and antitumor plants in a group of untreatable metastatic solid tumor patients, for whom no treatment other than the palliative therapy was available, because of lack of response to previous chemotherapies, poor clinical status or personal refusal of chemotherapy, and with a life expectancy less than 1 year. The pineal hormone melatonin (MLT) and 5-methoxytryptamine (5-MTT) were given orally at 100 mg/day in the dark period and at 5 mg in the light period of the day, respectively, in association with Aloe and Myrrh mixture at 10 ml thrice/day, Magnolia cortex at 500 mg twice/day and Bowellia at 1000 mg/day in patients with brain metastases. A complete response (CR) and partial response (PR) were achieved in 2 and in 8 patients. Then, an objective tumor regression was obtained in 10/132 (8%) patients. A stable disease (SD) was found in 61 patients, then a disease control (DC), consisting of CR plus PR plus SD, was achieved in 71/132 (54%) patients, whereas the remaining patients had a progressive disease (PD). A survival longer than 1 year was seen in 63/132 (48%) patients, and the percent of 2 and 3-year survival obtained in patients with response or SD was significantly longer than that found in patients with PD. The treatment was well tolerated and no relevant biological toxicity occurred. This preliminary study would demonstrate that a PNEIF combination with natural anticancer agents may prolong the survival time in patients, for whom no standard therapy was available other than the only palliative therapy, and with an expected survival less than 1 year.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43610447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}