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1. Importance of early diagnosis and surgical treatment of calcified amorphous tumor-related native valve endocarditis caused by Escherichia coli: a case report

Author

Shu Koito, Yuto Unoki, Keimei Yoshida, Sho Takemoto, Takayuki Uchida, and Takashi Matono

Subjects
Non-HACEK Gram-negative bacilli, Escherichia coli, Endocarditis, Calcified amorphous tumor, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Unlike Escherichia coli bacteremia, which is common, E. coli endocarditis is uncommon, particularly in patients with native valve, leading to its delayed diagnosis. Case presentation We present a case of infective endocarditis caused by E. coli in a 78-year-old Japanese man with type 2 diabetes, involving persistent bacteremia and vegetation on the mitral valve (measuring 18 × 4.2 mm in diameter). He presented with recurrent fever after antimicrobial treatment for pyelonephritis. He received antibiotic therapy for 6 weeks and required surgical removal of a calcified amorphous tumor and vegetation with mitral valvuloplasty 7 days after admission. Despite an episode of multiple cerebral infarctions, he recovered fully from the infection. Conclusions Follow-up blood cultures should be performed for Gram-negative bacilli bacteremia among patients with unknown focus and an atypical clinical course after treatment. Early diagnosis and aggressive surgical intervention are paramount to achieving good clinical outcomes.

Published
2022
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2. Effects of artificial nutrition and hydration on survival in patients with head and neck cancer and esophageal cancer admitted to palliative care units

Author

Sayuri Yokota, Koji Amano, Shunsuke Oyamada, Hiroto Ishiki, Isseki Maeda, Tomofumi Miura, Yutaka Hatano, Yu Uneno, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Kozue Suzuki, Tatsuya Morita, Masanori Mori, Satoshi Inoue, Naosuke Yokomichi, Kengo Imai, Hiroaki Tsukuura, Toshihiro Yamauchi, Akemi Shirado Naito, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Keiko Tanaka, Tina Kamei, Yukari Azuma, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Kiyofumi Oya, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Akihiro Sakashita, Ryo Matsunuma, Hana Takatsu, Takashi Yamaguchi, Satoko Ito, Toru Terabayashi, Jun Nakagawa, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Yusuke Hiratsuka, Keita Tagami, Hiroaki Watanabe, Takuya Odagiri, Tetsuya Ito, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Kazuhiro Kosugi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Satoshi Miyake, Junko Nozato, Specially Appointed, Tetsuji Iriyama, Keisuke Kaneishi, Mika Baba, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko Uehara, Eriko Satomi, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Takeshi Hirohashi, Jun Hamano, Natsuki Kawashima, Takashi Kawaguchi, Megumi Uchida, Ko Sato, Yoichi Matsuda, Satoru Tsuneto, Sayaka Maeda, Yoshiyuki Kizawa, and Hiroyuki Otani

Subjects
Head and neck cancer, Esophageal cancer, Enteral nutrition, Parenteral nutrition, Palliative care, Cachexia, Nutrition. Foods and food supply, TX341-641
Abstract

Summary: Background: The benefits of artificial nutrition and hydration in patients with head and neck cancer and esophageal cancer in the late stage remain unknown. We performed a secondary analysis of a cohort study to investigate the effects of enteral tube feeding (ETF) and parenteral nutrition and hydration (PNH) on survival in this population. Methods: Patients with head and neck cancer and esophageal cancer admitted to palliative care units were included. Information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate/total calorie intake, e.g., 75%≤/750 kcal/day≤ and

Published
2022
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3. The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units

Author

Koji Amano, Eriko Satomi, Shunsuke Oyamada, Hiroto Ishiki, Akihiro Sakashita, Tomofumi Miura, Isseki Maeda, Yutaka Hatano, Toshihiro Yamauchi, Kiyofumi Oya, Jun Nakagawa, Yusuke Hiratsuka, Takeshi Hirohashi, Tatsuya Morita, Masanori Mori, Satoshi Inoue, Naosuke Yokomichi, Kengo Imai, Hiroaki Tsukuura, Akemi Shirado Naito, Yu Uneno, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Hiromi Funaki, Keiko Tanaka, Kozue Suzuki, Tina Kamei, Yukari Azuma, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Ryo Matsunuma, Hana Takatsu, Takashi Yamaguchi, Satoko Ito, Toru Terabayashi, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Keita Tagami, Hiroaki Watanabe, Takuya Odagiri, Tetsuya Ito, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Kazuhiro Kosugi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Satoshi Miyake, Junko Nozato, Tetsuji Iriyama, Keisuke Kaneishi, Mika Baba, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko uehara, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Jun Hamano, Natsuki Kawashima, Takashi Kawaguchi, Megumi Uchida, Ko Sato, Yoichi Matsuda, Satoru Tsuneto, Sayaka Maeda, Yoshiyuki Kizawa, and Hiroyuki Otani

Subjects
Artificially administered nutrition, Artificially administered hydration, Parenteral nutrition, Parenteral hydration, Enteral tube feeding, Palliative care, Nutrition. Foods and food supply, TX341-641
Abstract

Summary: Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups (18–39, 40–59, 60–74, 75–89, and 90- years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18–39 and 40–59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n = 534), the proportions of patients categorized into the

Published
2021
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4. C-Reactive Protein and Its Relationship with Pain in Patients with Advanced Cancer Cachexia: Secondary Cross-Sectional Analysis of a Multicenter Prospective Cohort Study

Author

Koji Amano, Hiroto Ishiki, Tomofumi Miura, Isseki Maeda, Yutaka Hatano, Shunsuke Oyamada, Naosuke Yokomichi, Keita Tagami, Takuya Odagiri, Tetsuya Ito, Mika Baba, Tatsuya Morita, Masanori Mori, Satoshi Inoue, Kengo Imai, Hiroaki Tsukuura, Toshihiro Yamauchi, Akemi Shirado Naito, Yu Uneno, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Hiromi Funaki, Keiko Tanaka, Kozue Suzuki, Tina Kamei, Yukari Azuma, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Kiyofumi Oya, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Akihiro Sakashita, Ryo Matsunuma, Hana Takatsu, Takashi Yamaguchi, Satoko Ito, Toru Terabayashi, Jun Nakagawa, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Yusuke Hiratsuka, Hiroaki Watanabe, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Kazuhiro Kosugi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Satoshi Miyake, Junko Nozato, Tetsuji Iriyama, Keisuke Kaneishi, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko Uehara, Eriko Satomi, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Takeshi Hirohashi, Jun Hamano, Natsuki Kawashima, Takashi Kawaguchi, Megumi Uchida, Ko Sato, Yoichi Matsuda, Satoru Tsuneto, Sayaka Maeda, and Yoshiyuki Kizawa

Subjects
advanced cancer, cancer cachexia, C-reactive protein, pain, palliative care, Medicine (General), R5-920
Abstract

Background: Limited information is available on the relationship between C-reactive protein (CRP) levels and pain in advanced cancer. Objectives: To investigate the relationship between serum levels of CRP and subtypes of pain. Design: A secondary cross-sectional analysis of a prospective cohort study. Setting/Subjects: Patients with advanced cancer admitted to 23 palliative care units in Japan. Measurements: Patients rated the severity of pain on the numerical rating scale (NRS) and physicians evaluated pain on the integrated palliative care outcome scale (IPOS). Physicians assessed neuropathic pain and breakthrough pain based on their presence or absence. Patients were divided into four groups according to CRP levels. Comparisons were performed using the Kruskal?Wallis test or chi-squared test. To evaluate the relationship between CRP and subtypes of pain, adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in logistic models were calculated. Results: We divided 1513 patients into four groups: low CRP (n?=?234), moderate CRP (n?=?513), high CRP (n?=?352), and very high CRP (n?=?414). Spearman's correlation coefficient between CRP and pain NRS and that between CRP and pain IPOS were 0.15 (p?0.001) and 0.16 (p?

Published
2021
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6. The prevalence of artificially administered nutrition and hydration in different age groups among patients with advanced cancer admitted to palliative care units

Author

Jiro Miyamoto, Hiroto Ishiki, Kaoru Nishijima, Masayuki Ikenaga, Kazuki Kitade, Natsuki Kawashima, Keiji Shimizu, Akira Inoue, Takeshi Hirohashi, Shuji Hiramoto, Hoshu Hashimoto, Yoichi Matsuda, Junko Nozato, Keisuke Kaneishi, Kosuke Kuwahara, Takashi Ohmori, Junichi Shimoinaba, Kengo Imai, Takehiro Nakai, Satoshi Inoue, Yosuke Matsuda, Toshihiro Yamauchi, Ritsuko Yabuki, Takahiro Higashibata, Rena Kamura, Satoru Tsuneto, Tetsuya Ito, Masaya Ehara, Eri Matsumoto, Ryo Matsunuma, Yoshihisa Matsumoto, Keiko Tanaka, Masanori Mori, Yuko Uehara, Toru Terabayashi, Yutaka Hatano, Yuki Sumazaki Watanabe, Teruaki Uno, Hirofumi Katayama, Yuto Unoki, Takayuki Hisanaga, Tomohiro Nishi, Akemi Shirado Naito, Hiroaki Tsukuura, Ayumi Okizaki, Koji Amano, Shingo Hagiwara, Tetsuo Hori, Tomonao Okamura, Satoko Ito, Yusuke Hiratsuka, Ko Sato, Takeya Yamaguchi, Tatsuya Morita, Hiromi Funaki, Yukari Azuma, Akihiro Sakashita, Hana Takatsu, Takuhiro Yamaguchi, Satoshi Miyake, Sayaka Maeda, Hideyuki Kashiwagi, Ryoichi Nakahori, Jun Nakagawa, Takashi Yamaguchi, Keita Tagami, Nanao Ishibashi, Yaichiro Matsumoto, Naosuke Yokomichi, Kiyofumi Oya, Shu Koito, Miho Shimokawa, Eriko Satomi, Kazuhiro Kosugi, Megumi Uchida, Yasuhiro Shibata, Tina Kamei, Jun Hamano, Akira Hayakawa, Takashi Ikee, Tetsuji Iriyama, Takuya Odagiri, Yu Uneno, Shunsuke Nakashima, Mitsunori Miyashita, Nao Ikuta, Takashi Kawaguchi, Yoshiyuki Kizawa, Mika Baba, Saran Yoshida, Tetsuya Yamagiwa, Isseki Maeda, Akira Yoshioka, Shohei Ueno, Yuta Ishiyama, Hiroyuki Kohara, Shunsuke Oyamada, Ayako Kikuchi, Hiroyuki Otani, Kozue Suzuki, Hiroaki Watanabe, Shunsuke Kosugi, Takeru Okoshi, and Tomofumi Miura

Subjects
medicine.medical_specialty, Nutrition and Dietetics, Palliative care, Calorie, Younger age, business.industry, Parenteral hydration, Nutrition. Foods and food supply, Endocrinology, Diabetes and Metabolism, Parenteral nutrition, Advanced cancer, Artificially administered nutrition, Age groups, Internal medicine, medicine, Parenteral route, TX341-641, Enteral tube feeding, Prospective cohort study, business, Artificially administered hydration
Abstract

Summary: Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups (18–39, 40–59, 60–74, 75–89, and 90- years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18–39 and 40–59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n = 534), the proportions of patients categorized into the

Published
2021

7. How Successful Is Parenteral Oxycodone for Relieving Terminal Cancer Dyspnea Compared With Morphine? A Multicenter Prospective Observational Study

Author

Masanori Mori, Takashi Kawaguchi, Kengo Imai, Naosuke Yokomichi, Takashi Yamaguchi, Kozue Suzuki, Ryo Matsunuma, Hiroaki Watanabe, Isseki Maeda, Yuko Uehara, Tatsuya Morita, Satoshi Inoue, Hiroaki Tsukuura, Toshihiro Yamauchi, Akemi Shirado Naito, Yu Uneno, Akira Yoshioka, Shuji Hiramoto, Ayako Kikuchi, Tetsuo Hori, Yosuke Matsuda, Hiroyuki Kohara, Hiromi Fanaki, Keiko Tanaka, Tina Kamei, Yukari Azuma, Koji Amano, Teruaki Uno, Jiro Miyamoto, Hirofumi Katayama, Hideyuki Kashiwagi, Eri Matsumoto, Kiyofumi Oya, Takeya Yamaguchi, Tomonao Okamura, Hoshu Hashimoto, Shunsuke Kosugi, Nao Ikuta, Yaichiro Matsumoto, Takashi Ohmori, Takehiro Nakai, Takashi Ikee, Yuto Unoki, Kazuki Kitade, Shu Koito, Nanao Ishibashi, Masaya Ehara, Kosuke Kuwahara, Shohei Ueno, Shunsuke Nakashima, Yuta Ishiyama, Akihiro Sakashita, Hana Takatsu, Satoko Ito, Toru Terabayashi, Jun Nakagawa, Tetsuya Yamagiwa, Akira Inoue, Takuhiro Yamaguchi, Mitsunori Miyashita, Saran Yoshida, Yusuke Hiratsuka, Keita Tagami, Takuya Odagiri, Tetsuya Ito, Masayuki Ikenaga, Keiji Shimizu, Akira Hayakawa, Rena Kamura, Takeru Okoshi, Tomohiro Nishi, Kazuhiro Kosugi, Yasuhiro Shibata, Takayuki Hisanaga, Takahiro Higashibata, Ritsuko Yabuki, Shingo Hagiwara, Miho Shimokawa, Satoshi Miyake, Junko Nozato, Hiroto Ishiki, Tetsuji Iriyama, Keisuke Kaneishi, Mika Baba, Tomofumi Miura, Yoshihisa Matsumoto, Ayumi Okizaki, Yuki Sumazaki Watanabe, Yuko uehara, Eriko Satomi, Kaoru Nishijima, Junichi Shimoinaba, Ryoichi Nakahori, Takeshi Hirohashi, Jun Hamano, Natsuki Kawashima, Megumi Uchida, Ko Sato, Yoichi Matsuda, Yutaka Hatano, Satoru Tsuneto, Sayaka Maeda, Yoshiyuki Kizawa, and Hiroyuki Otani

Subjects
Lung Neoplasms, Palliative care, Subgroup analysis, Context (language use), law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, 030212 general & internal medicine, Lung cancer, General Nursing, Aged, Morphine, business.industry, Cancer, medicine.disease, respiratory tract diseases, Analgesics, Opioid, Dyspnea, Anesthesiology and Pain Medicine, 030220 oncology & carcinogenesis, Anesthesia, Neurology (clinical), business, Oxycodone, medicine.drug
Abstract

Parenteral morphine is widely used for dyspnea of imminently dying cancer patients (terminal dyspnea). However, the efficacy of other opioids such as oxycodone remains largely unknown.To explore the efficacy of parenteral oxycodone vs. morphine by continuous infusion over 24 hours in cancer patients with terminal dyspnea.This was a pre-planned subgroup analysis of a multicenter prospective observational study. Inclusion criteria were advanced cancer patients admitted to palliative care units, Eastern Cooperative Oncology Group performance status = 3-4, and a dyspnea intensity ≥2 on the Integrated Palliative care Outcome Scale (IPOS) for which oxycodone or morphine was initiated by continuous infusion. We measured dyspnea IPOS scores over 24 hours.We analyzed 164 patients who received oxycodone (n = 26) and morphine (n = 138) for dyspnea (median survival = 5 days). The mean age was 70 years, 58 patients (35%) had lung cancer, and 97 (59%) had lung metastases. Complete case analysis revealed that mean dyspnea IPOS scores decreased from 3.0 (standard deviation = 0.7) to 1.5 (0.7) in the oxycodone group (difference in means = 1.5; P 0.001), and from 2.9 (0.7) to 1.6 (1.0) in the morphine group (difference in means = 1.3; P 0.001). No significant between-group differences existed in the IPOS scores at 24 hours (P = 0.753). Adverse events were seen in no and 5 patients in the oxycodone and morphine groups, respectively.Parenteral oxycodone may be equally effective and safe as morphine in the treatment of terminal dyspnea in cancer patients. Future randomized controlled trials should confirm the efficacy and safety of opioids other than morphine for terminal dyspnea.

Published
2021
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8. Importance of early diagnosis and surgical treatment of calcified amorphous tumor-related native valve endocarditis caused by Escherichia coli: a case report

Author

Shu Koito, Yuto Unoki, Keimei Yoshida, Sho Takemoto, Takayuki Uchida, and Takashi Matono

Subjects
Male, Infectious Diseases, Early Diagnosis, Diabetes Mellitus, Type 2, Neoplasms, Escherichia coli, Humans, Endocarditis, Bacterial, Aged
Abstract

Background Unlike Escherichia coli bacteremia, which is common, E. coli endocarditis is uncommon, particularly in patients with native valve, leading to its delayed diagnosis. Case presentation We present a case of infective endocarditis caused by E. coli in a 78-year-old Japanese man with type 2 diabetes, involving persistent bacteremia and vegetation on the mitral valve (measuring 18 × 4.2 mm in diameter). He presented with recurrent fever after antimicrobial treatment for pyelonephritis. He received antibiotic therapy for 6 weeks and required surgical removal of a calcified amorphous tumor and vegetation with mitral valvuloplasty 7 days after admission. Despite an episode of multiple cerebral infarctions, he recovered fully from the infection. Conclusions Follow-up blood cultures should be performed for Gram-negative bacilli bacteremia among patients with unknown focus and an atypical clinical course after treatment. Early diagnosis and aggressive surgical intervention are paramount to achieving good clinical outcomes.

Published
2021

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