1.Effectiveness and long term safety of gabapentin in the management of neuropathic pain of terminally-ill cancer patients
Kengo Imai ; Masayuki Ikenaga ; Tomoyuki Kodama
Palliative Care Research 2010;6(1):101-108
Purpose: This study is aimed at the evaluation of the effectiveness and safety of gabapentin for the management of cancer-related neuropathic pain in terminally-ill cancer patients. Methods: We investigated terminally-ill cancer patients prescribed gabapentin for the management of cancer-related neuropathic pain, from November 200X to October 200X+2. We assessed average daily pain on the numerical rating scale (NRS) before administration, after one week, and while on a stable dose. Result: 44 patients were enrolled during this period and 19 patients completed the study. The medication and the survival period on average were 52.0 and 67.2 days, respectively. The average gabapentin daily dose after one week was 358 mg. The average period needed to reach a stable dose was 11.6 days and the average stable daily dose was 463 mg (male 620 mg, female 289 mg). The mean NRS decreased from 5.7 (before) to 2.1 (after one week, p<0.001) and 1.9 (stable dose, p<0.001), respectively. 57.9% of patients showed side effects, somnolence in 52.6%, delirium in 5.3%, tremor in 5.3%. Conclusion: Gabapentin can be expected to be effective and safe for managing cancer-related neuropathic pain for a long period even when in critical condition through careful titration. Palliat Care Res 2011; 6(1): 101-108
2.Effects of Hot Spring Bathing on Pregnancy and Labor
Saburou YAMAGIWA ; Tomonori SHIROTA ; Kimi YAMAUCHI ; Tomoyuki MIYATA ; Naoki KODAMA ; Takehiko MIYASITA ; Hisakazu KAWAI ; Masao KATOU
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2004;67(3):173-178
We investigated the influences of hot-spring bathing on the incidences of abortion and premature birth using questionnaires returned from 768 puerperal in-patients.
These patients were classified into four groups: 24 taking a hot-spring bath daily (group 1), 134 taking a bath with additives (group 2), 178 taking a plain water bath daily (group 3), and 35 taking a shower daily (group 4).
The incidence of threatened abortion among the ambulatory patients in each group was 4.2% for group 1, 11.9% for group 2, 9% for group 3, and 2.9% for group 4.
The incidence of threatened abortion among the hospitalized patients in each group was 4.2% for group 1, 6.7% for group 2, 4.5% for group 3, and 8.6% for group 4.
The incidence of threatened premature birth among the ambulatory patients in each group was 12.5% for group 1, 17.2% for group 2, 15.7% for group 3, and 14.3% for group 4.
The incidence of threatened premature birth among the hospitalized patients in each group was 0% for group 1, 7.5% for group 2, 3.4% for group 3, and 2.9% for group 4.
The incidence of vaginitis among the patients in each group was 50% for group 1, 43.4% for group 2, 46.6% for group 3, and 44.1% for group 4.
The incidence of premature rupture of membrane (PROM) among the patients in each group was 4.2% for group 1, 21.1% for group 2, 12.9% for group 3, and 22.9% for group 4.
The incidence of premature birth among the patients in each group was 0% for group 1, 3% for group 2, 2.8% for group 3, and 2.9% for group 4.
Among the 42 multiparas experiencing single delivery and being treated for threatened abortion, those who for more than 10 minutes daily showed a significant difference from ambulatory patients being treated for threatened abortion that required hospitalization.
Many of the 63 primiparas who did not use a labor accelerating medicine but bathed for more than 10 minutes daily delivered their babies within 1000 minutes.
Conclusion
The above suggests that pregnant women may bathe in hot-springs without problem but bathing for less than 10 minutes is recommended during early stage of pregnancy.
3.Effectiveness of the etiology-based antiemetic recommendations by a palliative care team for nausea in cancer patients
Kengo Imai ; Masayuki Ikenaga ; Tomoyuki Kodama ; Lena Kamura ; Keiko Tamura ; Megumi Takeohara ; Tomoko Takashita ; Tatsuya Morita
Palliative Care Research 2014;9(2):108-113
Purpose: To clarify the effect of a palliative care team intervention for nausea of cancer patients. Methods: The study participants were all cancer patients who were referred to a palliative care team in Yodogawa Christian Hospital in 2010, and had nausea with score 2 or over of the Support Team Assessment Schedule Japanese version (STAS-J). The causes of nausea were classified into 4 categories. Etiology-based antiemetic medications were recommended, and the intensities of nausea were assessed using the STAS-J on the day of referral, and 7 days after. Result: Among 27 patients were recruited for this study, 24 were assessed 7 days after. Nine patients had chemically induced nausea, eight had impaired gastric emptying, four had vestibular and central nervous system disturbance, and three had bowel obstruction. The mean STAS-J score significantly decreased from 3.0 (SD, 0.55) on the day of referral to 1.1 (0.80) after 7 days (p<0.001). Two patients had mild drowsiness. Conclusion: The recommendations of etiology-based antiemetics by the palliative care team may be effective for managing nausea in cancer patients.