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  1. Article ; Online: Efficacy and safety of tolvaptan for refractory fluid collection and edema in the terminal cancer patients

    Norimasa Tsuzuki / Masanobu Usui / Akihiro Itoh / Akihiko Futamura / Kazuki Imai

    Fujita Medical Journal, Vol 9, Iss 1, Pp 8-

    2023  Volume 11

    Abstract: Objective: Tolvaptan, a vasopressin V2 receptor antagonist, is an oral diuretic. Patients with terminal cancer develop marked fluid retention, and oral diuretics other than tolvaptan have been used as treatments without clear therapeutic effects. Herein, ...

    Abstract Objective: Tolvaptan, a vasopressin V2 receptor antagonist, is an oral diuretic. Patients with terminal cancer develop marked fluid retention, and oral diuretics other than tolvaptan have been used as treatments without clear therapeutic effects. Herein, we aimed to study the efficacy and safety of tolvaptan in patients with terminal cancer. Methods: Tolvaptan was administered at a dose of 7.5 mg/day to 29 patients (median, 72 years) between August 2017 and February 2020. The duration of tolvaptan treatment ranged from 1 to 85 days (mean, 18.5 days). Results: Median albumin (Alb) and transthyretin (TTR) levels on admission were 2.3 g/dL (1.2–4.2 g/dL) and 8.9 mg/dL (2.1–38.2 g/dL), respectively. Median Alb and TTR levels 1 month after treatment initiation remained at 2.3 g/dL (0.8–2.9 g/dL) and 8.6 mg/dL (0.8–23.7 mg/dL), respectively. Regarding renal function indicators, median blood urea nitrogen (BUN) and creatinine levels on admission were 19.9 mg/dL (8.6–49.3 mg/dL) and 0.81 mg/dL (0.38–2.25 mg/dL), respectively. Median BUN and creatinine levels 1 month after treatment initiation were 23.4 mg/dL (13.5–34.0 mg/dL) and 0.91 mg/dL (0.39–2.41 mg/dL), respectively. No patients had hypernatremia on admission, and no effects of tolvaptan on the blood sodium level were found 1 month after treatment initiation. The median potassium level on admission was 4.2 mEq/dL (2.9–5.0 mEq/dL); tolvaptan treatment had no effects on blood potassium level. Conclusions: Tolvaptan is effective and safe for treating fluid retention refractory to conventional diuretics in patients with terminal cancer.
    Keywords tolvaptan ; palliative medicine ; terminal cancer ; edema ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Effect of fat emulsion administration on blood coagulation in terminal lung cancer patients

    Takaki Kanie / Akihiko Futamura / Tomohiro Mizuno / Shigeki Yamada / Masanobu Usui

    Fujita Medical Journal, Vol 9, Iss 2, Pp 73-

    2023  Volume 79

    Abstract: Objectives: Patients with cancer, especially those with lung cancer, are at high risk of developing thrombosis. Intralipos® infusion 20% is contraindicated for thrombosis, and there is no consensus on whether it can be safely used in cases of advanced ... ...

    Abstract Objectives: Patients with cancer, especially those with lung cancer, are at high risk of developing thrombosis. Intralipos® infusion 20% is contraindicated for thrombosis, and there is no consensus on whether it can be safely used in cases of advanced cancer. We conducted a retrospective observational study to elucidate the impact of fat emulsion administration on blood coagulation in patients with terminal lung cancer. Methods: The subjects were patients with terminal lung cancer in the Department of Surgery and Palliative Medicine, Fujita Health University Nanakuri Memorial Hospital between January 2016 and December 2019. We compared changes in their blood coagulation profile before hospitalization and one month later. Results: There were a total of 213 patients with lung cancer—139 who were administered fat emulsion and 74 who were not—with no significant differences in baseline characteristics. In the fat emulsion administration group (n=27), the prothrombin time-international normalized ratio (PT-INR) and activated partial thromboplastin time (APTT), respectively, were 1.17±0.26 (mean±standard deviation) and 30.5±5.0 s at hospitalization and 1.16±0.12 and 31.2±4.2 s one month later with no significant differences. In the non-administration group (n=6), the PT-INR and APTT, respectively, were 1.44±0.43 and 30.6±5.2 s before hospitalization and 1.28±0.18 and 33.0±7.5 s one month later with no significant differences. Conclusions: We did not identify any changes in PT-INR and APTT after fat emulsion administration in patients with terminal lung cancer. There were also no new cases of thrombosis, suggesting that fat emulsions were administered safely in patients with terminal lung cancer.
    Keywords fat emulsion ; terminal lung cancer ; coagulation-fibrinolytic system ; prothrombin time ; activated partial thromboplastin time ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: The efficacy of prophylactic prochlorperazine injections at the initiation of opioid injections in preventing opioid-induced nausea and vomiting among patients with end-stage cancer

    Kazuki Imai / Akihiko Futamura / Miyo Murai / Akihiro Ito / Norimasa Tsuzuki / Masanobu Usui

    Fujita Medical Journal, Vol 9, Iss 4, Pp 270-

    2023  Volume 274

    Abstract: Objectives: Antiemetics have been widely recommended for treating opioid-induced nausea and vomiting (OINV). According to a previous study, the use of prophylactic prochlorperazine at the initiation of treatment with oral oxycodone was ineffective in ... ...

    Abstract Objectives: Antiemetics have been widely recommended for treating opioid-induced nausea and vomiting (OINV). According to a previous study, the use of prophylactic prochlorperazine at the initiation of treatment with oral oxycodone was ineffective in preventing OINV. This study examined whether prochlorperazine injection prevents OINV and induces drowsiness in patients with end-stage cancer (a different patient population from the previous study). Methods: Patients with end-stage cancer who received opioid injections for more than 5 days between April 2017 and March 2020 were classified into two groups: the opioid and prochlorperazine injection group and opioid alone group. Their systemic conditions were evaluated on the basis of the performance status and the palliative performance scale, a prognostic indicator. Results: Of 325 patients who received opioid treatment during the study period, 156 patients met the inclusion criteria. Of these, 103 patients and 53 patients were classified into the opioid and prochlorperazine injection group (prochlorperazine) and opioid alone groups (placebo) , respectively. There was no significant difference in characteristics, age, gender, performance status, or palliative performance scale results between the 2 groups. OINV developed in 4 patients in the opioid and prochlorperazine injection groups and in 1 patient in the opioid alone group. Given that sleep disturbance develops in many patients with end-stage cancer who had a specific condition, it is difficult to conclude regarding the relationship between prochlorperazine injection and drowsiness, although this study examined this relationship. Conclusions: As with the previous study, prophylactic prochlorperazine injection was ineffective in preventing OINV in patients who received opioid injections.
    Keywords oinv ; morphine ; oxycodone ; prochlorperazine injection ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Avoiding the incompatibility of peripheral parenteral nutrition solution and midazolam injection for intravenous sedation

    Akihiko Futamura / Takashi Higashiguchi / Takeshi Chihara / Yuka Yokota / Yoshinori Itani

    Fujita Medical Journal, Vol 7, Iss 2, Pp 35-

    2021  Volume 40

    Abstract: Objectives: We have observed white turbidity when a midazolam injection is administered from a lateral tube during the administration of a peripheral parenteral nutrition (PPN) solution. The aim of the current study was to determine how to avoid compound ...

    Abstract Objectives: We have observed white turbidity when a midazolam injection is administered from a lateral tube during the administration of a peripheral parenteral nutrition (PPN) solution. The aim of the current study was to determine how to avoid compound changes when co-administering a midazolam injection and a PPN solution. Methods: Midazolam solutions were prepared by diluting a midazolam injection with a 5% glucose intravenous infusion. We examined the formulation of the midazolam injection and a PPN solution at the concentrations used in a clinical setting for changes in appearance, pH, and midazolam content in test tubes and during administration conditions. Results: With a 1/4.8 dilution of midazolam in undiluted solution, clouding occurred. A strong correlation was revealed between the midazolam content as measured through high-performance liquid chromatography and the mixture’s midazolam concentration (R2=0.9918). The capture rate of midazolam infused with PPN solution was 91.0% at a 1/6 dilution, whereas it decreased to <90% at a 1/4.8 dilution. Conclusions: Our results suggest that the administration of a midazolam injection solution diluted by ≥6-fold with glucose solution or saline from a side tube during the administration of a PPN solution did not cause changes in composition.
    Keywords incompatibility ; midazolam ; parenteral nutrition ; sedation ; terminal cancer patient ; Medicine (General) ; R5-920
    Subject code 630
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Molecular-targeted therapy for advanced anaplastic thyroid cancer combined with nutritional support

    Yuka Maegawa / Takashi Higashiguchi / Akihiko Futamura / Norimasa Tsuzuki / Miyo Murai

    Fujita Medical Journal, Vol 5, Iss 1, Pp 25-

    2019  Volume 29

    Abstract: Management of anaplastic thyroid cancer (ATC) is often difficult because of its aggressive characteristics. Molecular-targeted therapy was recently introduced as an alternative therapeutic strategy for ATC; lenvatinib is a molecular-targeted agent that ... ...

    Abstract Management of anaplastic thyroid cancer (ATC) is often difficult because of its aggressive characteristics. Molecular-targeted therapy was recently introduced as an alternative therapeutic strategy for ATC; lenvatinib is a molecular-targeted agent that is currently indicated only in Japan for the treatment of ATC. Here we report the case of an 86-year-old Japanese woman with ATC who was treated with lenvatinib at our hospital and exhibited a remarkable response. Computed tomography showed tumor shrinkage by day 8 and stable disease until day 32. She maintained activities of daily living (ADLs) until shortly before her death. The patient’s resting energy expenditure and body composition were analyzed at the time of admission. Potential toxicity risk of lenvatinib was evaluated based on these data. Enteral nutrition for oral intake was supplied to compensate for her lack of dietary intake and to improve metabolism for the purpose of suppressing lenvatinib toxicity. She also engaged in physical rehabilitation to avoid developing sarcopenia, which is thought to be a risk factor of molecular-targeted therapy toxicity, and to maintain her activity level. We emphasize the importance of a team approach for providing an appropriate treatment regimen to maintain ADLs, which includes nutritional support, physical rehabilitation, and aggressive therapy with lenvatinib.
    Keywords thyroid carcinoma ; anaplastic thyroid cancer ; molecular-targeted therapy ; lenvatinib ; nutritional support ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2019-02-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Multicentric prospective study of effect of dietary intake on quality of life for patients with end-stage cancers

    Miyo Murai / Takashi Higashiguchi / Hiroshi Ohara / Nagato Katsura / Akihiko Futamura / Naomi Nakayama

    Fujita Medical Journal, Vol 6, Iss 1, Pp 1-

    2020  Volume 6

    Abstract: Objective: Impaired dietary intake (DI) contributes to deterioration of quality of life (QOL) in patients with end-stage diseases, including cancer, but the effects of DI on QOL specifically in terminal cancer has not been widely studied. Here, we ... ...

    Abstract Objective: Impaired dietary intake (DI) contributes to deterioration of quality of life (QOL) in patients with end-stage diseases, including cancer, but the effects of DI on QOL specifically in terminal cancer has not been widely studied. Here, we evaluated the relationship between DI and QOL in patients with end-stage cancers. Methods: We evaluated the energy amount of DI, performance status (PS) and QLQ-C15-PAL score of cancer patients with short prognoses in multicentre survey and analysed the parameters that influence QOL. Results: We recruited 33 patients in this study. In univariate analysis, DI was significantly associated with PS (P=0.002, r=–0.531), physical functioning (P=0.003, r=–0.503), fatigue (P=0.038, r=–0.362), and appetite loss (P=0.004, r=–0.490). Conclusions: Improved DI could contribute to QOL of patients with end-stage cancers.
    Keywords dietary energy intake ; quality of life ; terminal cancer patients ; palliative care ; Medicine (General) ; R5-920
    Language English
    Publishing date 2020-02-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Interleukin-8 and clinical symptoms can be prognostic indicators for advanced cancer patients with cachexia

    Miyo Murai / Takashi Higashiguchi / Akihiko Futamura / Hiroshi Ohara / Norimasa Tsuzuki / Yoshinori Itani / Takaaki Kaneko / Takeshi Chihara / Kan Shimpo / Naomi Nakayama

    Fujita Medical Journal, Vol 6, Iss 4, Pp 117-

    2020  Volume 121

    Abstract: Objectives: Prognostic prediction is a significant tool for selecting appropriate treatment in advanced cancer patients with cachexia, at a time when it is important to offer high-quality palliative care and improve quality of life until death. In this ... ...

    Abstract Objectives: Prognostic prediction is a significant tool for selecting appropriate treatment in advanced cancer patients with cachexia, at a time when it is important to offer high-quality palliative care and improve quality of life until death. In this retrospective study, we investigated the prognostic potential of serum cytokine level and various clinical symptoms by analyzing the pathological conditions and metabolic dynamics of cachexia in advanced cancer patients. Methods: One hundred and fifty-three advanced cancer patients who underwent palliative care and died at the Department of Surgery and Palliative Medicine, Fujita Health University Nanakuri Memorial Hospital between 1 January 2004 and 30 June 2007 were eligible for the study. We simultaneously assessed their blood factors and clinical symptoms at admission. All patients were divided into two groups according to median survival time to analyze the risk factors for prognosis. Results: Multivariate analysis revealed the following independent prognostic factors: interleukin (IL)-8 (odds ratio [OR]=4.17, 95% confidence interval [CI]=1.52–11.41, p=0.002), general fatigue (OR=1.22, 95%CI=1.03–1.45, p=0.019), anorexia (OR=1.19, 95%CI=1.04–1.37, p=0.008), dyspnea (OR=1.19, 95%CI=1.02–1.38, p=0.024), depression (OR=1.28, 95%CI=1.11–1.47, p<0.001), nausea (OR=1.25, 95%CI=1.05–1.48, p=0.007), dry mouth (OR=1.19, 95%CI=1.01–1.40, p=0.032), and overall assessment score (OR=1.05, 95%CI=1.02–1.09, p<0.001). Patients with low IL-8 (<1.347 pg/ml) and low overall assessment score (<26) had significantly better prognosis (both p<0.0001). Conclusions: High IL-8 level and clinical symptoms can be prognostic indicators for advanced cancer patients with cachexia.
    Keywords advanced cancer ; prognostic factors ; cytokines ; cachexia ; Medicine (General) ; R5-920
    Subject code 610 ; 616
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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