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1.
Medicine (Baltimore) ; 100(14): e25360, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832116

RESUMO

INTRODUCTION: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, and most patients in China are diagnosed at the intermediate or later stages, which is not suitable for the first line therapies. Transarterial chemoembolization (TACE) is a commonly selected therapeutic option for intermediate and later stage HCC in China, but patients often suffer from postembolization syndrome (PES), manifesting as fever, liver area pain, nausea, vomiting, paralyzed intestinal obstruction, and abdominal pain after TACE. We try to conduct a double blinded, randomized, placebo-controlled clinical trial to observe whether Chaihu Guizhi decoction (CGD), a classic traditional Chinese formula, could prophylactically alleviate the incidence of PES in HCC patients after TACE. METHODS: Patients will be randomly assigned sequentially in a 1:1 ratio by using preformed randomization envelopes. After TACE procedures, patients in the treatment group will be administrated with Chinese herbal formula CGD, and patients in the control group with CGD simulations, twice a day, continuously for 7 days. The outcomes are the incidence of PES hospitalization and, complications. SPSS version 22 (IBM, Chicago, IL) will be used for the data, and a P < .05 will be considered statistically significant. CONCLUSIONS: The findings will explore the prophylactic effect of CGD in alleviating the incidence of PES following TACE in HCC patients. TRIAL REGISTRATION: OSF Registration number: DOI 10.17605/OSF.IO/FKRSN.


Assuntos
Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/métodos , Medicamentos de Ervas Chinesas/administração & dosagem , Febre/prevenção & controle , Neoplasias Hepáticas/terapia , Náusea/prevenção & controle , Vômito/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Projetos de Pesquisa , Síndrome , Vômito/etiologia , Adulto Jovem
2.
Medicine (Baltimore) ; 100(10): e24947, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725858

RESUMO

BACKGROUND: Bowel preparation is essential to the success of colonoscopy. However, many patients cannot finish the preparation due to nausea and vomiting when taking polyethylene glycol (PEG). Dopamine-2 receptor antagonists, such as domperidone and sulpiride, are classical antiemetic drugs. This study aimed to explore the effect of domperidone and sulpiride on reducing the discomforts associated with PEG. METHODS: Patients scheduled for colonoscopy were enrolled and randomly allocated into 3 groups. Patients in the domperidone group (Dom group) or sulpiride group (Sul group) took 2 doses of domperidone or sulpiride before PEG. Patients in the control group (Con group) followed the regular routine of PEG. Discomforts during bowel preparation and the quality of bowel preparation were assessed. RESULTS: A total of 306 patients were enrolled. The participants in the Dom group and Sul group completed PEG better and had fewer abdominal discomforts than those in the Con group. The severity of nausea and abdominal fullness was lower in the Dom group and Sul group. The quality of bowel preparation was better in the Dom group and Sul group than Con group. CONCLUSIONS: Domperidone and sulpiride could reduce the PEG-related discomfort and improve the quality of bowel preparation. This method may be a promising way to improve the satisfaction of bowel preparation for both patients and endoscopists.


Assuntos
Antieméticos/uso terapêutico , Catárticos/efeitos adversos , Colonoscopia , Náusea/epidemiologia , Polietilenoglicóis/efeitos adversos , Vômito/epidemiologia , Adulto , Idoso , Colo/diagnóstico por imagem , Domperidona/uso terapêutico , Feminino , Humanos , Incidência , Mucosa Intestinal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/diagnóstico , Náusea/prevenção & controle , Satisfação do Paciente , Índice de Gravidade de Doença , Sulpirida/uso terapêutico , Resultado do Tratamento , Vômito/induzido quimicamente , Vômito/diagnóstico , Vômito/prevenção & controle
3.
Medicine (Baltimore) ; 100(7): e24588, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607790

RESUMO

BACKGROUND: Nausea and vomiting are among the most common and distressing side effects of chemotherapy. Difference in views about the effectiveness of auricular acupuncture (AA) versus electroacupuncture (EA) of chemotherapy-induced nausea and vomiting (CINV) lies at the heart of the debate. The aim of this study is to compare the antiemetic efficacy and safety of AA and EA for CINV. METHODS: One hundred twenty participants, 18 to 75 years old malignant tumors will receiving chemotherapy with cisplatin, will be recruited and randomized into 3 groups equally, Group A (the AA group), Group B (the EA group), and Group C (the control group). The participants in Group A and Group B will receive AA or EA regimens, alternatively, beginning on the day before first day of chemotherapy for a third consecutive cycles. All participants will continue to receive conventional treatment. The incidence and severity of CINV will be assessed using the definition and classification of nausea and vomiting (NCI-CTC AE4.0) and the MASCC (Multinational Association for Supportive Care in Cancer) Antiemesis Tool (MAT). Secondary outcome measures include the degree of abdominal distension, the first time of flatus and defecation, and life quality. Additionally, adverse events will also be documented during the period of the treatment. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness and safety of AA versus EA for CINV following cisplatin-based regimens. TRAIL REGISTRATION: This study is registered with the Chinese Clinical Trial Registry: ChiCTR2000040942.


Assuntos
Acupuntura Auricular , Antineoplásicos/efeitos adversos , Cisplatino/efeitos adversos , Eletroacupuntura , Náusea/etiologia , Náusea/prevenção & controle , Vômito/etiologia , Vômito/prevenção & controle , Adolescente , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Rev. enferm. UFPE on line ; 15(1): [1-14], jan. 2021. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-1145789

RESUMO

Objetivo: verificar o efeito da acupuntura no controle de náuseas e vômitos em pacientes submetidos à quimioterapia. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa da literatura, entre 2008 a 2018, na BVS (Biblioteca Virtual de Saúde) e na MEDLINE via PUBMED. Analisaram-se os artigos pela leitura reflexiva e criteriosa acerca das principais informações e elementos que compõem a temática nos estudos. Resultados: resultaram-se 15 artigos em inglês, espanhol e português. Percebeu-se que o efeito da acupuntura no controle de náuseas e vômitos induzidos pela quimioterapia foi satisfatório em 13 dos 15 estudos que compuseram esta revisão, mostrando uma diminuição desses sintomas durante e após o tratamento. Destacaram-se, entre os métodos evidenciados nos estudos, a acupuntura clássica e a eletroacupuntura. Conclusão: avalia-se que a acupuntura é uma prática integrativa e complementar aos tratamentos convencionais na oncologia, pois melhora a qualidade de vida dos pacientes em tratamento quimioterápico.(AU)


Objective: to verify the effect of acupuncture on the control of nausea and vomiting in patients undergoing chemotherapy. Method: this is a bibliographic, descriptive, integrative literature review type study, between 2008 and 2018, at the VHL (Virtual Health Library) and at MEDLINE via PUBMED. The articles were analyzed by a reflexive and careful reading about the main information and elements that make up the theme in the studies. Results: the result was 15 articles in English, Spanish and Portuguese. It was noticed that the effect of acupuncture in the control of nausea and vomiting induced by chemotherapy was satisfactory in 13 of the 15 studies that composed this review, showing a decrease in these symptoms during and after treatment. Among the methods evidenced in the studies, classical acupuncture and electroacupuncture were highlighted. Conclusion: acupuncture is considered an integrative practice and complementary to conventional treatments in oncology, because it improves the quality of life of patients in chemotherapy treatment.


Objetivo: verificar el efecto de la acupuntura en el control de náuseas y vómitos en pacientes sometidos a quimioterapia. Método: se trata de una revisión bibliográfica, descriptiva, integradora de la literatura, entre 2008 y 2018, en la BVS (Virtual Health Library) y MEDLINE vía PUBMED. Los artículos fueron analizados mediante una lectura reflexiva y atenta sobre las principales informaciones y elementos que componen el tema de los estudios. Resultados: se publicaron 15 artículos en inglés, español y portugués, se notó que el efecto de la acupuntura en el control de náuseas y vómitos inducidos por quimioterapia fue satisfactorio en 13 de los 15 estudios que componen esta revisión, mostrando una disminución de estos síntomas durante y después del tratamiento. Entre los métodos evidenciados en los estudios se destacaron la acupuntura clásica y la electroacupuntura. Conclusión: se evalúa que la acupuntura es una práctica integradora y complementaria a los tratamientos convencionales en oncología, ya que mejora la calidad de vida de los pacientes sometidos a quimioterapia.(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Vômito/prevenção & controle , Terapia por Acupuntura , Eletroacupuntura , Acupressão , Acupuntura Auricular , Náusea/prevenção & controle , Neoplasias/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Epidemiologia Descritiva , MEDLINE
5.
Support Care Cancer ; 29(1): 213-222, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32338316

RESUMO

PURPOSE: To compare rates of complete response (no emesis, retching, or rescue antiemetics) in the late phase (days 4-7 post-chemotherapy) of cycle 1 between transdermal granisetron and oral ondansetron in cervical, endometrial, or vaginal cancer survivors undergoing chemoradiation at The University of Texas MD Anderson Cancer Center and LBJ Hospital in Houston, TX. METHODS: In this non-blinded parallel design trial, eligible patients received a granisetron patch replaced every 7 days or 8 mg of ondansetron thrice daily continued for 72 h after chemotherapy completion. Data were collected on medication compliance, episodes of chemotherapy-induced nausea and vomiting (CINV), use of rescue antiemetics, and effects of CINV on quality of life. RESULTS: Seventy-five survivors receiving chemoradiation for cervical (n = 61), endometrial (n = 12), or vaginal (n = 2) cancer were electronically randomized to transdermal granisetron (n = 41) or oral ondansetron (n = 34). In the late phase of cycle 1, the rate of complete response was 49.8% (95% CI, 35.2-64.3%) for transdermal granisetron and 39.7% (95% CI, 24.4-56.1%) for oral ondansetron. The posterior probability that transdermal granisetron achieved a higher success rate in controlling late-onset CINV compared with oral ondansetron was 82%. During the acute phase (day 1 post-chemotherapy) of cycles 2 and 3, transdermal granisetron patients used more rescue antiemetics than oral ondansetron patients (p = 0.006 and p = 0.003, respectively). Otherwise, no between-group differences in CINV events were observed. Medication compliance and the effect of CINV on quality of life were similar between groups. CONCLUSION: Transdermal granisetron was 82% more like to control CINV than oral ondansetron in the late phase of cycle 1 and performed similarly to oral ondansetron in all other cycles. Transdermal granisetron should be considered an option as prophylactic antiemetic therapy for gynecologic cancer survivors undergoing chemoradiation.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Granisetron/uso terapêutico , Náusea/prevenção & controle , Ondansetron/uso terapêutico , Vômito/prevenção & controle , Administração Cutânea , Adulto , Antineoplásicos/uso terapêutico , Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias do Endométrio/tratamento farmacológico , Feminino , Granisetron/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/tratamento farmacológico , Ondansetron/administração & dosagem , Qualidade de Vida/psicologia , Indução de Remissão , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias Vaginais/tratamento farmacológico , Vômito/induzido quimicamente , Vômito/tratamento farmacológico
6.
Medicine (Baltimore) ; 99(38): e22150, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957337

RESUMO

BACKGROUND: Nausea and vomiting are the most common complications after chemotherapy, which cannot be completely controlled even with commonly prescribed antiemetic drugs, particularly in patients receiving highly emetogenic chemotherapy Acupuncture therapy is an effective replacement method for chemotherapy-induced nausea and vomiting (CINV), which effectiveness and safety have been observed by many clinicians. However, different acupuncture treatments have various effectiveness. Based on enough clinical researches, the study aims to uses Bayesian network meta-analysis (NMA) to evaluate the effectiveness of different acupuncture therapies used for preventing CINV. METHODS: Authors will search PubMed/Medline, Cochrane library, Web of Science, Ebsco, Ovid/Embase, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine from setup time to July 2020. All randomized control trails meet the standard will be included. Quality evaluation of included studies will be implemented with Cochrane risk-of-bias tool. STATA 14.0 will be used to perform pairwise meta-analysis. Addis 1.16.8 (University Medical Center Groningen (UMCG), Groningen, NL) and OpenBUGS 3.2.3 (Medical Research Council (MRC), London, UK) will be used to conduct NMA. RESULTS: The results of this review will generate a comprehensive review of current evidence and be published on a peer-reviewed journal. CONCLUSION: The result of this systematic review and Bayesian NMA may offer better options for patients in relieving CINV.Systematic review registration number: INPLASY202070070.


Assuntos
Terapia por Acupuntura/métodos , Antineoplásicos/efeitos adversos , Náusea/prevenção & controle , Projetos de Pesquisa , Vômito/prevenção & controle , Teorema de Bayes , Humanos , Náusea/induzido quimicamente , Metanálise em Rede , Revisões Sistemáticas como Assunto , Vômito/induzido quimicamente
7.
Medicine (Baltimore) ; 99(33): e21559, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872006

RESUMO

OBJECTIVE: To systematically evaluate the efficacy and safety of antiemetic regimen with aprepitant in the prevention of chemotherapy-induced nausea and vomiting (CINV) and provide updated information for clinical practice. METHODS: Pubmed, Embase, the Cochrane Library, and 3 Chinese literature databases were systematically searched. Randomized controlled trials comparing standard regimen (5-hydroxytryptamine-3 receptor antagonist and glucocorticoid) with aprepitant triple regimen (aprepitant plus the standard regimen) for preventing CINV were screened. Literature selection, data extraction, and quality evaluation were performed by 2 reviewers independently. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in the meta-analysis using RevMan 5.3 software. RESULTS: A total of 51 randomized controlled trials were finally included in the systematic review. Compared with the standard regimen, the aprepitant triple regimen significantly improved the complete response in the overall (OR 1.88, 95% CI 1.71-2.07), acute (OR 1.96, 95% CI 1.65-2.32) and delayed (OR 1.96, 95% CI 1.70-2.27) phases, regardless of emetogenic risk of chemotherapy. Aprepitant could also significantly enhance the proportions of patients who have no emesis, nausea, or use of rescue medication respectively in the overall, acute and/or delayed phases. Aprepitant was found to be associated with decreased risk of constipation (OR 0.85, 95% CI 0.74-0.97), but increased the incidence of hiccup (OR 1.26, 95% CI 1.05, 1.51). There were no statistically significant differences between the 2 groups on other safety outcomes. CONCLUSION: The aprepitant triple regimen is effective for the prevention of CINV in patients being treated with moderately or highly emetogenic chemotherapy, and has a significant tendency to reduce the risk of constipation and increase the incidence of hiccup.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Aprepitanto/uso terapêutico , Náusea/prevenção & controle , Vômito/prevenção & controle , Humanos , Náusea/induzido quimicamente , Ensaios Clínicos Controlados Aleatórios como Assunto , Vômito/induzido quimicamente
8.
Cochrane Database Syst Rev ; 8: CD012977, 2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32767571

RESUMO

BACKGROUND: Asthma is an illness that commonly affects adults and children, and it serves as a common reason for children to attend emergency departments. An asthma exacerbation is characterised by acute or subacute worsening of shortness of breath, cough, wheezing, and chest tightness and may be triggered by viral respiratory infection, poor compliance with usual medication, a change in the weather, or exposure to allergens or irritants. Most children with asthma have mild or moderate exacerbations and respond well to first-line therapy (inhaled short-acting beta-agonists and systemic corticosteroids). However, the best treatment for the small proportion of seriously ill children who do not respond to first-line therapy is not well understood. Currently, a large number of treatment options are available and there is wide variation in management. OBJECTIVES: Main objective - To summarise Cochrane Reviews with or without meta-analyses of randomised controlled trials on the efficacy and safety of second-line treatment for children with acute exacerbations of asthma (i.e. after first-line treatments, titrated oxygen delivery, and administration of intermittent inhaled short-acting beta2-agonists and oral corticosteroids have been tried and have failed) Secondary objectives - To identify gaps in the current evidence base that will inform recommendations for future research and subsequent Cochrane Reviews - To categorise information on reported outcome measures used in trials of escalation of treatment for acute exacerbations of asthma in children, and to make recommendations for development and reporting of standard outcomes in future trials and reviews - To identify relevant randomised controlled trials that have been published since the date of publication of each included review METHODS: We included Cochrane Reviews assessing interventions for children with acute exacerbations of asthma. We searched the Cochrane Database of Systematic Reviews. The search is current to 28 December 2019. We also identified trials that were potentially eligible for, but were not currently included in, published reviews. We assessed the quality of included reviews using the ROBIS criteria (tool used to assess risk of bias in systematic reviews). We presented an evidence synthesis of data from reviews alongside an evidence map of clinical trials. Primary outcomes were length of stay, hospital admission, intensive care unit admission, and adverse effects. We summarised all findings in the text and reported data for each outcome in 'Additional tables'. MAIN RESULTS: We identified 17 potentially eligible Cochrane Reviews but extracted data from, and rated the quality of, 13 reviews that reported results for children alone. We excluded four reviews as one did not include any randomised controlled trials (RCTs), one did not provide subgroup data for children, and the last two had been updated and replaced by subsequent reviews. The 13 reviews included 67 trials; the number of trials in each review ranged from a single trial up to 27 trials. The vast majority of comparisons included between one and three trials, involving fewer than 100 participants. The total number of participants included in reviews ranged from 40 to 2630. All studies included children; 16 (24%) included children younger than two years of age. Most of the reviews reported search dates older than four years. We have summarised the published evidence as outlined in Cochrane Reviews. Key findings, in terms of our primary outcomes, are that (1) intravenous magnesium sulfate was the only intervention shown to reduce hospital length of stay (high-certainty evidence); (2) no evidence suggested that any intervention reduced the risk of intensive care admission (low- to very low-certainty evidence); (3) the risk of hospital admission was reduced by the addition of inhaled anticholinergic agents to inhaled beta2-agonists (moderate-certainty evidence), the use of intravenous magnesium sulfate (high-certainty evidence), and the use of inhaled heliox (low-certainty evidence); (4) the addition of inhaled magnesium sulfate to usual bronchodilator therapy appears to reduce serious adverse events during hospital admission (moderate-certainty evidence); (5) aminophylline increased vomiting compared to placebo (moderate-certainty evidence) and increased nausea and nausea/vomiting compared to intravenous beta2-agonists (low-certainty evidence); and (6) the addition of anticholinergic therapy to short-acting beta2-agonists appeared to reduce the risk of nausea (high-certainty evidence) and tremor (moderate-certainty evidence) but not vomiting (low-certainty evidence). We considered 4 of the 13 reviews to be at high risk of bias based on the ROBIS framework. In all cases, this was due to concerns regarding identification and selection of studies. The certainty of evidence varied widely (by review and also by outcome) and ranged from very low to high. AUTHORS' CONCLUSIONS: This overview provides the most up-to-date evidence on interventions for escalation of therapy for acute exacerbations of asthma in children from Cochrane Reviews of randomised controlled trials. A vast majority of comparisons involved between one and three trials and fewer than 100 participants, making it difficult to assess the balance between benefits and potential harms. Due to the lack of comparative studies between various treatment options, we are unable to make firm practice recommendations. Intravenous magnesium sulfate appears to reduce both hospital length of stay and the risk of hospital admission. Hospital admission is also reduced with the addition of inhaled anticholinergic agents to inhaled beta2-agonists. However, further research is required to determine which patients are most likely to benefit from these therapies. Due to the relatively rare incidence of acute severe paediatric asthma, multi-centre research will be required to generate high-quality evidence. A number of existing Cochrane Reviews should be updated, and we recommend that a new review be conducted on the use of high-flow nasal oxygen therapy. Important priorities include development of an internationally agreed core outcome set for future trials in acute severe asthma exacerbations and determination of clinically important differences in these outcomes, which can then inform adequately powered future trials.


Assuntos
Antiasmáticos/uso terapêutico , Asma/terapia , Broncodilatadores/uso terapêutico , Progressão da Doença , Revisões Sistemáticas como Assunto , Doença Aguda , Administração por Inalação , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Aminofilina/administração & dosagem , Aminofilina/efeitos adversos , Antiasmáticos/administração & dosagem , Antibacterianos/uso terapêutico , Asma/tratamento farmacológico , Viés , Broncodilatadores/administração & dosagem , Criança , Pré-Escolar , Antagonistas Colinérgicos/uso terapêutico , Hélio , Humanos , Lactente , Tempo de Internação , Antagonistas de Leucotrienos/uso terapêutico , Sulfato de Magnésio/administração & dosagem , Sulfato de Magnésio/efeitos adversos , Sulfato de Magnésio/uso terapêutico , Náusea/induzido quimicamente , Náusea/prevenção & controle , Oxigênio/administração & dosagem , Respiração com Pressão Positiva , Ensaios Clínicos Controlados Aleatórios como Assunto , Vômito/induzido quimicamente , Trabalho Respiratório/efeitos dos fármacos
9.
Support Care Cancer ; 28(10): 5031-5036, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32601854

RESUMO

PURPOSE: People with cancer face an elevated risk of infection and severe sequelae from COVID-19. Dexamethasone is commonly used for antiemetic prophylaxis with systemic therapy for cancer. However, dexamethasone is associated with increased risk of viral and respiratory infections, and causes lymphopenia, which is associated with worse outcomes during COVID-19 infections. Our purpose was to minimize dexamethasone exposure during antiemetic prophylaxis for systemic therapy for solid tumors during the COVID-19 pandemic, while maintaining control of nausea and emesis. METHODS: We convened an expert panel to systematically review the literature and formulate consensus recommendations. RESULTS: No studies considered the impact of dexamethasone-based antiemetic regimens on the risk and severity of COVID-19 infection. Expert consensus recommended modifications to the 2019 Cancer Care Ontario Antiemetic Recommendations. CONCLUSION: Clinicians should prescribe the minimally effective dose of dexamethasone for antiemetic prophylaxis. Single-day dexamethasone dosing is recommended over multi-day dosing for regimens with high emetogenic risk excluding high-dose cisplatin, preferably in combination with palonosetron, netupitant, and olanzapine. For regimens with low emetogenic risk, 5-HT3 antagonists are recommended over dexamethasone.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Betacoronavirus , Infecções por Coronavirus , Dexametasona/uso terapêutico , Náusea/prevenção & controle , Neoplasias/tratamento farmacológico , Pandemias , Pneumonia Viral , Vômito/prevenção & controle , Antineoplásicos/uso terapêutico , Infecções por Coronavirus/epidemiologia , Humanos , Náusea/induzido quimicamente , Ontário , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Vômito/induzido quimicamente
10.
J Vasc Interv Radiol ; 31(8): 1292-1299, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32654960

RESUMO

PURPOSE: To assess the use of opioid analgesics and/or antiemetic drugs for pain and nausea following selective chemoembolization with doxorubicin-based conventional (c)-transarterial chemoembolization versus drug-eluting embolic (DEE)-transarterial chemoembolization for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From October 2014 to 2016, 283 patients underwent 393 selective chemoembolization procedures including 188 patients (48%) who underwent c-transarterial chemoembolization and 205 (52%) who underwent DEE-transarterial chemoembolization. Medical records for all patients were retrospectively reviewed. Administration of postprocedural opioid and/or antiemetic agents were collated. Time of administration was stratified as phase 1 recovery (0-6 hours) and observation (6-24 hours). Logistic regression model was used to investigate the relationship of transarterial chemoembolization type and use of intravenous and/or oral analgesic and antiemetic medications while controlling for other clinical variables. RESULTS: More patients treated with DEE-transarterial chemoembolization required intravenous analgesia in the observation (6-24 hours) phase (18.5%) than those treated with c-transarterial chemoembolization (10.6%; P = .033). Similar results were noted for oral analgesic agents (50.2% vs. 31.4%, respectively; P < .001) and antiemetics (17.1% vs. 7.5%, respectively; P = .006) during the observation period. Multivariate regression models identified DEE-transarterial chemoembolization as an independent predictor for oral analgesia (odds ratio [OR], 1.84; P = .011), for intravenous and oral analgesia in opioid-naïve patients (OR, 2.46; P = .029) and for antiemetics (OR, 2.56; P = .011). CONCLUSIONS: Compared to c-transarterial chemoembolization, DEE-transarterial chemoembolization required greater amounts of opioid analgesic and antiemetic agents 6-24 hours after the procedure. Surgical data indicate that a persistent opioid habit can develop even after minor surgeries, therefore, caution should be exercised, and a regimen of nonopiate pain medications should be considered to reduce postprocedural pain after transarterial chemoembolization.


Assuntos
Analgésicos Opioides/administração & dosagem , Carcinoma Hepatocelular/tratamento farmacológico , Quimioembolização Terapêutica , Neoplasias Hepáticas/tratamento farmacológico , Dor/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/efeitos adversos , Antieméticos/administração & dosagem , Antieméticos/efeitos adversos , Carcinoma Hepatocelular/patologia , Quimioembolização Terapêutica/efeitos adversos , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Náusea/prevenção & controle , Dor/diagnóstico , Dor/etiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Vômito/induzido quimicamente , Vômito/prevenção & controle
11.
Int J Hematol ; 112(4): 577-583, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32656635

RESUMO

Post-transplantation cyclophosphamide (PTCy) is a new method to prevent graft-versus-host disease after allogeneic hematopoietic cell transplantation. Although the use of dexamethasone is recommended as prophylaxis against chemotherapy-induced nausea and vomiting (CINV) for patients who receive high-dose cyclophosphamide, corticosteroids cannot be used during PTCy administration to exploit depletion of alloreactive T cells. Thus, CINV may not be adequately controlled in this situation. We retrospectively examined antiemetic efficacy of the combination of a 5-hydroxytryptamine-3 receptor antagonist (5-HT3 RA) and a NK1 receptor antagonist (NK1 RA) in 36 patients who received PTCy, and compared this efficacy with that of the same combination together with dexamethasone in 27 patients conditioned with cyclophosphamide and total body irradiation (CY/TBI). The proportion of patients who had no vomiting during the acute phase of PTCy administration was 81%, and was lower than 100% in the CY/TBI group (p = 0.02). Our results suggest that prevention of CINV using 5-HT3 RA and NK1 RA during PTCy administration is suboptimal and that addition of antiemetic is necessary in patients who receive PTCy.


Assuntos
Ciclofosfamida/efeitos adversos , Náusea/induzido quimicamente , Náusea/prevenção & controle , Antagonistas do Receptor de Neuroquinina-1/uso terapêutico , Cuidados Pós-Operatórios/efeitos adversos , Antagonistas do Receptor 5-HT3 de Serotonina/uso terapêutico , Vômito/induzido quimicamente , Vômito/prevenção & controle , Adulto , Antieméticos/administração & dosagem , Dexametasona/uso terapêutico , Quimioterapia Combinada , Feminino , Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Condicionamento Pré-Transplante/métodos , Transplante Homólogo , Adulto Jovem
12.
Zhen Ci Yan Jiu ; 45(7): 574-7, 2020 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-32705833

RESUMO

OBJECTIVE: To observe the effect of ginger-partitioned moxibustion intervention on gastrointestinal reaction, the quality of life, the counts of blood platelet (PLT) and white blood cells (WBC) after chemotherapy in lung cancer patients. METHODS: The lung cancer patients treated with chemotherapy were randomized into observation group (30 cases) and control group (30 cases). In the control group, the intravenous injection with Tropisetron(5 mg) was given 1 h before chemotherapy. In the observation group, in addition to the same treatment as the control group, 2 hours after chemotherapy, ginger-partitioned moxibustion was applied to bilateral Zusanli (ST36), bilateral Neiguan (PC6) and bilateral Tianshu (ST25) for 20 min each time. The treatments were conducted once daily for 3 days. Separately, 2 days before chemotherapy, 24 h and 7 days after chemotherapy, the gastrointestinal reaction score and the score of the quality of life, the PLT and WBC counts were observed in the two groups. RESULTS: The effective rate of the gastrointestinal reaction degree in the observation group were higher than those in the control group 24 h and 7 days after chemotherapy (P<0.05). Twenty-four hours after chemotherapy, the score of the quality of life, the PLT and WBC counts were lower as compared with those before the treatment in both groups respectively(P<0.05). Seven days after chemotherapy, the score of the quality of life, the PLT and WBC counts in the observation group were higher than those in the control group (P<0.05). CONCLUSION: The ginger-partitioned moxibustion achieves the definite clinical effect of the prevention of nausea and vomiting induced by chemotherapy in lung cancer. This therapy is simple in operation, high in safety, absent in obvious adverse reactions and high in patient's compliance.


Assuntos
Antineoplásicos/efeitos adversos , Gengibre , Neoplasias Pulmonares , Moxibustão , Náusea/prevenção & controle , Vômito/prevenção & controle , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Qualidade de Vida
14.
Crit Rev Oncol Hematol ; 152: 103012, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32593142

RESUMO

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is the most common non-haematological toxicity of chemotherapy. METHODS: A systematic review and meta-analysis comparing short course (1-2 days) with long course (3+ days) dexamethasone in preventing CINV was performed in accordance with the PRISMA statement. RESULTS: 1535 articles were screened to identify the 11 studies included in the review. Nine studies of 1892 patients were included in meta-analysis. There was no significant difference in complete response of nausea and vomiting between a short or long course of dexamethasone (RR 0.98, 95 % CI 0.89-1.07, p = 0.58). There was a lower risk of adverse events with a short course of dexamethasone (RR 0.80, 95 % CI 0.64-0.99, p = 0.04). CONCLUSION: There was no significant difference between a short or long course of dexamethasone in preventing nausea or vomiting, but a short course was associated with fewer adverse effects. PROSPERO protocol: CRD42019133785.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Dexametasona/uso terapêutico , Náusea/prevenção & controle , Vômito/prevenção & controle , Humanos , Náusea/induzido quimicamente , Vômito/induzido quimicamente
15.
Bull Cancer ; 107(7-8): 800-812, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32418660

RESUMO

Antineoplastic drug induced nausea and vomiting are common adverse events in cancer care of paediatric patients ; therefore, prevention and management of these adverse events is a major concern for healthcare professionals. There are common features between paediatric and adult patients in terms of the emetogenic level depending on antineoplastic agents or about available medicines. However, there are also specificities for paediatric population including individual risk factors of emesis or nausea assessment for example. Knowledge relative to available medicines is also limited in the paediatric population, especially for recent medicines. This review aims to provide a comprehensive overview about antiemetics in paediatric oncology to clinicians and other healthcare professionals involved in paediatric cancer care. First of all, we describe physiopathological paediatric specificity, risk factors and clinical assessment of antineoplastic drug induced nausea and vomiting. Secondly, we focus on available medicines and also address the issue of complementary and alternative medicines.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Náusea/terapia , Neoplasias/tratamento farmacológico , Vômito/terapia , Terapia por Acupuntura/métodos , Corticosteroides/uso terapêutico , Aromaterapia/métodos , Criança , Humanos , Náusea/induzido quimicamente , Náusea/classificação , Náusea/prevenção & controle , Fitoterapia/métodos , Fatores de Risco , Vômito/induzido quimicamente , Vômito/classificação , Vômito/prevenção & controle
16.
BMC Palliat Care ; 19(1): 56, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321488

RESUMO

BACKGROUND: Olanzapine is an atypical antipsychotic that has affinity for many central nervous system receptors. Its efficacy is supported by several studies in the prevention and treatment of chemotherapy-induced nausea and vomiting. No recommendations exist on the antiemetic use of olanzapine in the palliative care setting. The aim of this work is to complete the initial work of Fonte et al. published in 2015, to determine whether the literature supports the use of olanzapine as an antiemetic in palliative situations and, in practice, to propose a therapeutic schema adapted to the palliative setting. METHODS: Systematic review of the literature according to the PRISMA criteria. We searched the PubMed, Cochrane, RefDoc, EMBase databases and the gray literature databases. The bibliographic search was conducted between November 2016 and August 2017. RESULTS: Thirteen articles were included: 2 case studies, 3 case series, 3 retrospective studies, 2 prospective studies, 2 literature reviews. All studies concluded on the efficacy of olanzapine as an antiemetic in the palliative care setting. No serious adverse effects were reported. Based on the data from the literature review, we propose a therapeutic scheme adapted to the palliative care context. CONCLUSION: Action of olanzapine on many receptors and its tolerance profile make it an interesting antiemetic treatment in palliative medicine. But to date, studies are scarce and have a low statistical power. Further investigation is therefore needed to determine the benefit of this treatment in palliative care patients, compared to usual treatments.


Assuntos
Antieméticos/uso terapêutico , Olanzapina/normas , Medicina Paliativa/instrumentação , Antieméticos/normas , Antipsicóticos/normas , Antipsicóticos/uso terapêutico , Humanos , Náusea/tratamento farmacológico , Náusea/prevenção & controle , Olanzapina/uso terapêutico , Medicina Paliativa/métodos , Medicina Paliativa/tendências , Vômito/tratamento farmacológico , Vômito/prevenção & controle
17.
Obstet Gynecol ; 135(5): 1145-1151, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32282591

RESUMO

OBJECTIVE: To compare the effect of exteriorized with in situ uterine repair on intraoperative nausea and vomiting during elective cesarean delivery under spinal anesthesia using a phenylephrine infusion. METHODS: This study was a randomized double-blinded controlled trial of 180 women undergoing elective cesarean delivery using a standardized anesthetic protocol. Patients were randomized to exteriorization (n=90) or in situ uterine repair (n=90). The spinal anesthetic, phenylephrine infusion, and blood pressure management were all standardized. The primary outcome was postdelivery intraoperative nausea and vomiting using a 4-point scale (0-3). A sample size of 80 patients per group was needed to demonstrate a 50% reduction in intraoperative nausea and vomiting with in situ repair. RESULTS: From November 2015 through July 2018, 180 patients were enrolled. Incidence of postdelivery intraoperative nausea and vomiting was 39% in the exteriorization group compared with 22% in the in situ group (P=.01). Incidence of hypotension (80% vs 50%; P<.001) and tachycardia (33% vs 17%; P=.02) was significantly higher in the exteriorization group, and more phenylephrine boluses were administered to this group (median 4 boluses [first and third quartiles 1.25-7] vs 2 [0-4]; P<.001). The duration of surgery, blood loss, and postoperative hemoglobin decline were similar between groups. CONCLUSION: In situ uterine repair for elective cesarean delivery under spinal anesthesia with a phenylephrine infusion is associated with less postdelivery intraoperative nausea and vomiting. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02587013.


Assuntos
Antieméticos/administração & dosagem , Parto Obstétrico/efeitos adversos , Histerotomia/métodos , Complicações Intraoperatórias/prevenção & controle , Fenilefrina/administração & dosagem , Adulto , Raquianestesia , Cesárea/métodos , Método Duplo-Cego , Feminino , Humanos , Hipotensão/induzido quimicamente , Hipotensão/epidemiologia , Incidência , Complicações Intraoperatórias/epidemiologia , Complicações Intraoperatórias/etiologia , Náusea/epidemiologia , Náusea/etiologia , Náusea/prevenção & controle , Gravidez , Taquicardia/induzido quimicamente , Taquicardia/epidemiologia , Resultado do Tratamento , Útero/cirurgia , Vômito/epidemiologia , Vômito/etiologia , Vômito/prevenção & controle
18.
Crit Rev Oncol Hematol ; 149: 102939, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32259776

RESUMO

A substantial proportion of cancer patients experience chemotherapy-induced nausea and vomiting (CINV) despite the use of antiemetic drugs. Prevalent genetic polymorphisms involved in antiemetic drug metabolism, drug transport and receptor pathways likely affect the effectiveness of antiemetics. Knowledge on which polymorphisms to integrate into individualised clinical care is needed. We did a systematic review evaluating the association between polymorphisms and effectiveness of antiemetics in cancer patients receiving moderately to highly emetogenic chemotherapy. Twenty studies n = 2331 evaluated eight polymorphisms in five candidate genes involved in 5-HT3 antagonist pathways. HTR3C C1214G increased the risk of acute chemotherapy-induced vomiting in the dominant model (odds ratio (OR) = 2.67, 95 % confidence interval (CI): 1.08-6.63). ABCB1 C3435T reduced the risk of acute CINV in the recessive model (OR = 0.60, 95 % CI: 0.44-0.81). Future studies should evaluate candidate genes that affect pharmacogenetics of other antiemetics beside 5-HT3 antagonists.


Assuntos
Antieméticos/uso terapêutico , Antineoplásicos/efeitos adversos , Sistema Enzimático do Citocromo P-450 , Náusea/prevenção & controle , Neoplasias/tratamento farmacológico , Farmacogenética , Receptores 5-HT3 de Serotonina , Antagonistas do Receptor 5-HT3 de Serotonina/uso terapêutico , Vômito/prevenção & controle , Antineoplásicos/uso terapêutico , Sistema Enzimático do Citocromo P-450/efeitos dos fármacos , Sistema Enzimático do Citocromo P-450/genética , Humanos , Náusea/induzido quimicamente , Náusea/genética , Polimorfismo Genético/genética , Receptores 5-HT3 de Serotonina/efeitos dos fármacos , Receptores 5-HT3 de Serotonina/genética , Vômito/induzido quimicamente , Vômito/genética
19.
Support Care Cancer ; 28(11): 5335-5342, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32128615

RESUMO

PURPOSE: We assessed the efficacy of aprepitant (APR) or 10 or 5 mg OLN (OLN10 or OLN5) plus ondansetron and dexamethasone for chemotherapy-induced nausea/vomiting (CINV) prophylaxis in patients receiving high-emetogenic chemotherapy (HEC). METHODS: Patients who received doxorubicin + cyclophosphamide or cisplatin were given intravenous ondansetron and dexamethasone prior to chemotherapy and oral dexamethasone on days 2-4 and randomized 1:1:1 to receive APR125 on day 1 and APR80 on days 2-3 or OLN10 or OLN5 on days 1-4. Matched placebo controls were used. The primary endpoint was no nausea in ≤ 120 h. Secondary endpoints included CINV severity, complete response (CR) rate, adverse effects (AE), and quality of life. RESULTS: Of 141 patients, 104 received AC and 37 received cisplatin. The no-nausea rates were 33% (APR), 43.2% (OLN10; p = 0.24), and 37% (OLN5; p = 0.87). Grades 2-4 nausea were experienced by fewer patients for OLN10 than for APR (24-120 h, 8.7% vs. 27.7%, respectively; p = 0.02; overall period, 19.6% vs. 40.4%, respectively; p = 0.03). The median visual analog scale nausea score from 24 to 120 h was significantly lower for OLN10 (2.3) than for APR (1.2, p = 0.03). The degrees of vomiting, CR, and AE were similar between the APR and OLN10 groups. CINV was similar between the OLN5 and APR groups. CONCLUSIONS: Nausea was less severe for OLN10 than for APR in patients receiving HEC, but other measures were similar. CINV prevention efficacy was comparable between OLN5 and APR.


Assuntos
Aprepitanto/uso terapêutico , Dexametasona/administração & dosagem , Náusea/prevenção & controle , Olanzapina/administração & dosagem , Ondansetron/administração & dosagem , Vômito/prevenção & controle , Adulto , Idoso , Antieméticos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Quimioprevenção/métodos , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Dexametasona/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Quimioterapia Combinada , Eméticos/administração & dosagem , Eméticos/efeitos adversos , Feminino , Humanos , Quimioterapia de Indução/efeitos adversos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Olanzapina/efeitos adversos , Ondansetron/efeitos adversos , Placebos , Qualidade de Vida , Resultado do Tratamento , Vômito/induzido quimicamente , Adulto Jovem
20.
Ann Hematol ; 99(4): 867-875, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32036421

RESUMO

A survey within hematopoietic stem cell transplant (HSCT) centers of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) was performed in order to describe current antiemetic prophylaxis in patients undergoing HSCT. The multicenter survey was performed by a questionnaire, covering the main areas on chemotherapy-induced nausea and vomiting (CINV): antiemetic prophylaxis guidelines used, antiemetic prophylaxis in different conditioning regimens, and methods of CINV evaluation. The survey was carried out in November 2016, and it was repeated 6 months after the publication of the Multinational Association of Supportive Care in Cancer (MASCC)/European Society for Medical Oncology (ESMO) specific guidelines on antiemetic prophylaxis in HSCT. The results show a remarkable heterogeneity of prophylaxis among the various centers and a significant difference between the guidelines and the clinical practice. In the main conditioning regimens, the combination of a serotonin3 receptor antagonist (5-HT3-RA) with dexamethasone and neurokin1 receptor antagonist (NK1-RA), as recommended by MASCC/ESMO guidelines, increased from 0 to 15% (before the publication of the guidelines) to 9-30% (after the publication of the guidelines). This study shows a lack of compliance with specific antiemetic guidelines, resulting mainly in under-prophylaxis. Concerted strategies are required to improve the current CINV prophylaxis, to draft shared common guidelines, and to increase the knowledge and the adherence to the current recommendations for CINV prophylaxis in the specific field of HSCT.


Assuntos
Antieméticos/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Náusea/prevenção & controle , Condicionamento Pré-Transplante/efeitos adversos , Vômito/prevenção & controle , Aloenxertos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fidelidade a Diretrizes , Pesquisas sobre Serviços de Saúde , Humanos , Itália , Agonistas Mieloablativos/efeitos adversos , Agonistas Mieloablativos/uso terapêutico , Náusea/induzido quimicamente , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricos , Transplante Autólogo , Vômito/induzido quimicamente
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