Symptom and Quality of Life Improvement in LUX-Lung 8, an Open-Label Phase III Study of Second-Line Afatinib Versus Erlotinib in Patients With Advanced Squamous Cell Carcinoma of the Lung After First-Line Platinum-Based Chemotherapy

Introduction

In the phase III LUX-Lung 8 trial, afatinib significantly improved progression-free survival (PFS) and overall survival (OS) versus erlotinib in patients with squamous cell carcinoma (SCC) of the lung progressing during or after platinum-based chemotherapy. Patient-reported outcomes (PROs) and health-related quality of life (QoL) in these patients are presented.

Dyspnea: Assessment and treatment

Dyspnea, or breathlessness, is a very distressing and prevalent symptom for patients with terminal cancer. Assessment for this symptom is generally poorly conducted, and it is therefore frequently underdiagnosed and inadequately treated. This paper outlines several tools found in the literature that may be beneficial to us in assessing this symptom. There will also be a full report on the application of these scales as used in a hospital audit of all in-patients at the Queensway- Carleton Hospital in Nepean, Ontario, during the month of June 1995. Results of this hospital audit revealed that 33% of all patients in hospital complained of some degree of breathlessness on both the Linear Analogue Scale Assessment and the Borg Scale. However, when the Modified Medical Research Council Dyspnea Scale and the Oxygen Cost Diagram Scale were used 75.6% and 78.5% respectively now complained of significant shortness of breath interfering with their quality of life. We also found that patients experiencing dyspnea were 39% more likely to complain of other symptoms than patients with no shortness of breath and were 55% more likely to report other symptoms as being severe. A short section will also outline the medical and nursing management of dyspnea and will include a discussion of possibly correcting the cause of breathlessness, environmental issues, and pharmacological management of dyspnea. It is advocated that during the terminal stages of a patient's illness, when assessment tools are no longer feasible or possible, that a breathing comfortably approach be adopted for patient and family comfort.Presented as an invited lecture at the 8th International Symposium: Supportive Care in Cancer, Toronto, Canada, 19–22 June 1996     

Video-assisted thoracoscopic diaphragm plication using a running suture technique is durable and effective

Objective

Surgeons have hesitated to adopt minimally invasive diaphragm plication techniques because of technical limitations rendering the procedure cumbersome or leading to early failure or reduced efficacy. We sought to demonstrate efficacy and durability of our thoracoscopic plication technique using a single running suture.

中药方剂对重症肺炎患者炎症因子水平的影响

目的探讨中药方剂对重症肺炎患者炎症因子水平的影响。方法选取2014年3月—2016年8月我院收治的92例重症肺炎患者,根据治疗方案分组,各46例。两组均给予祛痰、抗感染、机械通气等常规治疗,在此基础上对照组给予头孢哌酮钠/舒巴坦钠治疗,观察组给予中药方剂治疗。对比两组治疗前后肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白介素-6(IL-6)水平变化情况。结果治疗前两组患者TNF-α、CRP、IL-6水平比较,差异无统计学意义(P0.05),治疗后观察组TNF-α、CRP、IL-6水平均低于对照组,差异有统计学意义(P0.05)。结论对重症肺炎患者给予中药方剂治疗,有利于降低炎症因子水平,改善预后。     

未诊断的淋巴瘤患儿镇静后发生严重呼吸困难1例

由麻醉医生参与的小儿镇静效果好, 安全性高, 但风险仍较大。本文报道四川大学华西第二医院2022年7月1例因颈部包块待诊, 行颈部增强CT检查, 给予吸入麻醉后发生严重呼吸困难, 进行气管插管抢救的病例。     

COPD稳定期病人双水平气道正压通气康复治疗后的随访研究

目的：探讨双水平气道正压通气（ＢＩＰＡＰ）对ＣＯＰＤ稳定期患者的长期疗效。方法：回顾性对照研究。对在本所接受ＢＩＰＡＰ治疗的２６例稳定期ＣＯＰＤ病人进行２年的随访,并与同期的２４例病人对照。结果：与对照组相比,接受了ＢＩＰＡＰ治疗后的稳定期ＣＯＰＤ病人在较长时间内（２年）气促仍能得到缓解,住院和急诊就诊次数减少。但两组病人的病死率无显著性差别。结论：ＢＩＰＡＰ无创通气是稳定期ＣＯＰＤ病人有效的康复治疗手段     

A Comparison of Pain,Fatigue, Dyspnea and their Impact on Quality of Life in Pulmonary Rehabilitation Participants with Chronic Obstructive Pulmonary Disease

In addition to dyspnea and fatigue, pain is a prevalent symptom in chronic obstructive pulmonary disease (COPD). Understanding the relative prevalence, magnitude, and interference with aspects of daily living of these symptoms can improve COPD management. Therefore, the purposes of this study were to: (1) compare the prevalence and magnitude of dyspnea, fatigue, and pain and how each limits aspects of daily living; (2) determine the association between pain and the other two symptoms; and (3) assess the impact of these symptoms on quality of life in COPD. Participants were recruited from pulmonary rehabilitation programs. Pain, dyspnea, and fatigue were measured using the Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), and Dyspnea Inventory (DI), respectively. Quality of life was measured using the Clinical COPD Questionnaire (CCQ). The prevalence of dyspnea, fatigue, and pain were 93%, 77%, and 74%, respectively. Individuals with COPD reported similar severity scores of the three symptoms. Dyspnea interfered with general activity more than pain (F_1.7,79.9 = 3.1, p < 0.05), whilst pain interfered with mood (F_{1.8, 82.7} = 3.6, p < 0.05) and sleep (F_1,46 = 7.4, p < 0.01) more than dyspnea and fatigue. These three symptoms were moderately-to-highly correlated with each other (ρ = 0.49–0.78, p < 0.01) and all individually impacted quality of life. In summary, pain is a common symptom in addition to dyspnea and fatigue in COPD; all three interfere similarly among aspects of daily living with some exceptions. Accordingly, management of COPD should include a multifaceted approach that addresses pain as well as dyspnea and fatigue.