There is little evidence of the effectiveness of aromatherapy massage in palliative care despite its popularity.
This study aimed to investigate the effects of a 30-minute single session of ...aromatherapy massage at night time on quality of sleep and fatigue in palliative care.
A randomized controlled trial from January 2018 to March 2019. After being stratified by sex, participants were randomly assigned to an aromatherapy massage group and a control group. The effects of aromatherapy massage were evaluated on the massage day and the next day using the Richards-Campbell Sleep Questionnaire and the Brief Fatigue Inventory.
Of the 74 participants, data of 27 participants in the treatment group and 30 participants in the control group were analyzed. Analysis of covariance indicated that quality of sleep and fatigue did not improve owing to the aromatherapy massage, although usual fatigue in preceding 24 hours and enjoyment of life subscales of the Brief Fatigue Inventory showed signs of contribution (P = 0.07 and 0.09, respectively). Post hoc analyses indicated that higher age and performance status were factors with moderate correlation with better sleep (P = 0.03; r = 0.45 and P = 0.03; r = 0.40, respectively), and that older patients tended to experience greater improvement in fatigue (P = 0.02; r = −0.47).
A single aromatherapy massage session is no more effective than not having a massage in improving sleep quality in palliative care settings. However, older patients and those in poor health conditions may benefit from aromatherapy massage.
Current consensus recognizes the benefits of early intervention in palliative care consultation teams (PCCTs). As consultants, we should now attempt to improve the quality of our teams by utilizing a ...method mainly used in the business field. We aimed to investigate the effects of iterative evaluation of customer satisfaction surveys, filled by physicians and ward nurses in this study, for quality improvement of PCCTs.
In October 2019, the participants filled the first questionnaire survey about palliative care and PCCTs at a 678-bed hospital, and improvement areas were uncovered. Refinements were planned and implemented, and then reevaluated using the second questionnaire survey in March 2020.
In addition to the characteristics of our clients evaluated from approximately 500 valid responses, the first survey showed that the response rate of the questionnaire, knowledge of palliative care and PCCTs, and publicity of the PCCT were recognized as issues needing attention. We planned to contrive ways to collect questionnaires, hold monthly workshops for palliative care, launch newsletters of palliative care, and go on client rounds. The second survey revealed improvements in the physicians' response rate (p = 0.02), the accuracy rate of application of PCCTs in Japan (p < 0.01), and ward nurses' confidence in opioid use (p = 0.04) and tendency toward easier accessibility to the PCCT (p = 0.07).
Continual quality improvements through iterative, customer satisfaction survey-driven evaluation are a widely established practice in the business field. By using this appropriately, we could enable PCCTs to improve their quality.
The extracellular signal-regulated kinase (ERK) is one of the principal hub proteins that transmit growth signals from upstream oncogene products including Ras and BRaf to downstream effector ...proteins. However, there are both reports supporting and refuting the increase in ERK activity in cancer tissues expressing the active Ras and BRaf proteins. We considered that the cell density might account for this discrepancy. To examine this possibility, we prepared Madin-Darby canine kidney (MDCK) cells that expressed an active HRas, NRas, KRas, or BRaf and an ERK biosensor based on the principle of Förster resonance energy transfer (FRET). As we anticipated, expression of the active Ras or BRaf increased ERK activity at low cell densities. However, the ERK activity was markedly suppressed at high cell densities irrespective of the expression of the active Ras or BRaf. Western blotting analysis with Phos-tag gel revealed the decrease of tyrosine and threonine-diphosphorylated active ERK and the increase of tyrosine-monophosphorylated inactive ERK at high cell density. In addition, we found that calyculin A, an inhibitor for PPP-subfamily protein serine/threonine phosphatases, decreased the tyrosine-monophosphorylated ERK. Our study suggests that PPP-subfamily phosphatases may be responsible for cell density-dependent ERK dephosphorylation in cancer cells expressing active Ras or BRaf protein.
Carmustine (BCNU) implants (Gliadel® Wafer, Eisai Inc., New Jersey, USA) for the treatment of malignant gliomas (MGs) were shown to enhance overall survival in comparison to placebo in controlled ...clinical trials in the United States and Europe. A prospective, multicenter phase I/II study involving Japanese patients with MGs was performed to evaluate the efficacy, safety, and pharmacokinetics of BCNU implants. The study enrolled 16 patients with newly diagnosed MGs and 8 patients with recurrent MGs. After the insertion of BCNU implants (8 sheets maximum, 61.6 mg BCNU) into the removal cavity, various chemotherapies (including temozolomide) and radiotherapies were applied. After placement, overall and progression-free survival rates and whole blood BCNU levels were evaluated. In patients with newly diagnosed MGs, the overall survival rates at 12 months and 24 months were 100.0% and 68.8%, and the progression-free survival rate at 12 months was 62.5%. In patients with recurrent MGs, the progression-free survival rate at 6 months was 37.5%. There were no grade 4 or higher adverse events noted due to BCNU implants, and grade 3 events were observed in 5 of 24 patients (20.8%). Whole blood BCNU levels reached a peak of 19.4 ng/mL approximately 3 hours after insertion, which was lower than 1/600 of the peak BCNU level recorded after intravenous injections. These levels decreased to less than the detection limit (2.00 ng/mL) after 24 hours. The results of this study involving Japanese patients are comparable to those of previous studies in the United States and Europe.
Abstract
The EGFR-Ras-ERK pathway is a major growth signaling cascade in many human cancers. Consequently, constitutive activation of Ras, which is found in 30% of human cancers, is believed to lead ...to constitutive ERK activation and, thereby, uncontrolled cell growth. Recently, we have reported that the cell growth is controlled not only by the basal ERK activity but also by the frequency of stochastic ERK activity pulses. In the present study, we have evaluated the effect of Ras on the temporal dynamics of Erk activity by using fluorescent resonance energy transfer (FRET) biosensors. We found that, in Madin-Darby Canine kidney (MDCK) cells expressing constitutively active HRAS (HRASV12), ERK activity stimulated by epidermal growth factor (EGF) and 12-O-tetradecanoylphorbol-13-acetate (TPA), was markedly attenuated in comparison with the parent MDCK cells. Furthermore, the stochastic ERK activity pulses observed in the parent MDCK cells were almost completely abolished in the HRASV12-expressing MDCK cells. These observations have revealed that the temporal regulation of ERK activity is significantly different between normal and HRASV12-expressing cells.
Citation Format: Noriyuki Kawabata, Michiyuki Matsuda. Constitutively-active HRAS suppresses stochastic Erk activity pulses in Madin-Darby canine kidney cells. abstract. In: Proceedings of the AACR Special Conference on RAS Oncogenes: From Biology to Therapy; Feb 24-27, 2014; Lake Buena Vista, FL. Philadelphia (PA): AACR; Mol Cancer Res 2014;12(12 Suppl):Abstract nr A13. doi: 10.1158/1557-3125.RASONC14-A13
To introduce early palliative care to patients, we have proactively used a palliative care screening tool to identify needs. We have emphasized not doing work in a routine manner, rather seeking to ...improve by continuous reevaluations. Because of a lack of feedback regarding changes in screening scores and actionable solutions derived from it, we executed a retrospective study about the effectiveness of our palliative care team and the identification of problems. All 91 cases studied meaningfully ameliorated their focused symptoms. However, we could not verify our team’s effectiveness because the backgrounds of patients who were eligible but not involved with our team differed significantly. The current study suggested that some patients missed opportunities to receive palliative care. We need to strengthen the system used with our patients as a safety-net so as not to overlook care opportunities by utilizing more effective screening methodology.
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