The Effect of Fan Therapy for Dyspnea in Patients with Chronic Progressive Disease: Systematic Review and Meta-analysis

Objective: To evaluate the efficacy of fan therapy for the relief of dyspnea in patients with chronic progressive disease. Methods: A systematic electronic database search of all available articles published before October 23, 2019 was conducted using Ichushi-Web of the Japan Medical Abstract Society databases, CENTRAL, EMBASE, and MEDLINE. In addition, a hand-search for updates was performed using PubMed on June 30, 2020 and December 7, 2021. The inclusion criteria were: 1) any RCTs comparing the effect of fan therapy with any other intervention, and 2) patients aged ≥18 years. Exclusion criteria were: 1) duplicate references, and 2) conference presentations. Results: We identified 110 studies, of which 10 met our criteria for inclusion. Finally, five studies were used in the meta-analysis. Fan therapy significantly improved dyspnea in patients with chronic progressive disease compared to control groups with a standardized mean difference of −1.43 (95% confidence interval: −2.70 to −0.17, I2=94%, p<0.0001). Conclusion: Fan therapy was found to be effective in reducing dyspnea in chronic progressive disease.

A Case of Lung Cancer: Malignant Pericardial Effusion Which Was Drained by Subcutaneously Placed Port System

Pericardial effusion due to malignancy often needs drainage, however, it is difficult to repeat to puncture, especially in the case of little effusion space. Here we report a case of non-small cell lung cancer, 71 years old male, who was diagnosed in 2012 and had malignant pericardial effusion as a post-operative recurrence in June 2018. After several chemotherapy regimens, he suffered from dyspnea on effort due to increasing pericardial effusion. We performed pericardial drainage, but 2 months later pericardial effusion had increased again. The need of repeating of pericardial drainage was estimated, so we placed subcutaneously placed port system into his pericardial space. Thereafter, we drained pericardial effusion through it on demand for his dyspnea. Gradually his circulatory status had been exacerbated and he died on 36th day after the procedure. In the case of malignant pericardial effusion, the subcutaneously placed port system may be useful because repeated aspiration can be done by single procedure of pericardial puncture. It may keep quality of life of patients and more cases should be experienced and assessed.

The impact of water immersion recovery to the neck after short distance swimming on pulmonary functions in individuals with the past history of bronchial asthma / 体力科学

<p>The purpose of this study was to assess an impact of water immersion recovery after short distance swimming on the recovery process in pulmonary functions in individuals with the past history of bronchial asthma (PHA). Eleven Japanese healthy males with PHA (23 years) volunteered to perform two bouts of a 25-m maximal front crawl session in an indoor pool. The two bouts were separated by either 10-min of recovery on the land (L-session) or the same condition with water immersion to the neck (W-session), using a counterbalanced crossover design. Water temperature was 30 °C. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV_1.0) (%predicted) were measured according to the following time course; at baseline (REST), water immersion to the neck (WIN) before the swimming session, after 5-min (REC-5) and 10-min (REC-10) recovery with the assessment of dyspnea sensation (ADS) at the same time point. %FVC and %FEV_1.0 at WIN, REC-5 and REC-10 in the W-session were significantly lower than those REST. A similar reduction was observed at WIN in the L-session, and %FEV_1.0 at REC-5 was significantly different from those REST. The subjects had higher ADS at REC-5 in both sessions compared with those REST. %FVC and %FEV_1.0 at REC-5 and REC-10 in W-session were significantly lower than those at REC-5 and REC-10 in L-session. These results indicates a negative impact of not only water immersion recovery but also recovery on the land after short distance swimming on pulmonary function in individuals with PHA.</p>

Continuous treatment with EGFR-TKI in the terminal stage for non-small cell lung cancer patients who initially responded to EGFR-TKI

<b>Purpose</b>: We evaluated the efficacy of continuous administration of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in patients with end-stage non-small cell lung cancer. <b>Method</b>: Our study included 33 patients most recently treated with EGFR-TKI for non-small cell lung cancer that had once been responsive to EGFR-TKI but eventually showed worsening. We compared patients who discontinued EGFR-TKI within one month (n=16) after their disease progressed and those who continued the treatment (n=17). <b>Results</b>: The median survival time was significantly longer in patients who continued EGFR-TKI (191 days) than in those who discontinued the treatment (62 days) (p=0.0098). Adverse events experienced by patients who continued the treatment included Grade 1 eruption in six, Grade 2 eruption in one, Grade 1 diarrhea in one and Grade 1 AST/ALT elevation in four. All of these adverse events were manageable. <b>Conclusion</b>: In patients with non-small cell lung cancer initially responsive to EGFR-TKI but eventually showing worsening and becoming unfit for cytotoxic anticancer drugs, continuous administration of EGFR-TKI may extend their survival with acceptable toxicity. Further investigation of this strategy is warranted. Palliat Care Res 2011; 6(1): 119-125