Publications by authors named "Akechi T"

Article Synopsis
  • Many cancer patients suffer from psychological distress and low quality of life during or after treatment, facing barriers to accessing support, making digital psychological interventions a potential solution.
  • A comprehensive review of 136 randomized controlled trials identified effective digital interventions including cognitive behavioral therapy (CBT), health education, and virtual reality therapy (VRT), which significantly reduced psychological distress and improved quality of life compared to non-active controls.
  • Digital CBT and VRT were particularly effective in addressing various issues like depression, anxiety, and fatigue, while CBT was the best for insomnia, and mindfulness-based interventions specifically reduced fear of cancer recurrence, highlighting the need for more high-quality trials in this area.
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  • Olanzapine is an atypical antipsychotic that helps prevent nausea and vomiting, particularly after highly emetogenic chemotherapy (HEC), but it can cause side effects like hyperglycemia and drowsiness.
  • A systematic review and meta-analysis assessed the effectiveness of olanzapine combined with standard triplet antiemetic therapy compared to triplet therapy alone, focusing on outcomes like nausea control and adverse effects.
  • Results showed that adding olanzapine significantly improved nausea and vomiting prevention in both acute and delayed phases with minimal adverse effects, indicating it can be beneficial for patients undergoing HEC.
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  • Research lacks a standardized multi-day antiemetic regimen for chemotherapy, making it difficult to assess efficacy and safety.
  • A comprehensive search revealed no direct comparisons between multi-day and single-day antiemetic regimens, with variations in study quality and treatment protocols hindering robust analysis.
  • Preliminary findings indicate that three-drug combination therapies, particularly using aprepitant, may outperform two-drug regimens; further research is needed to better define antiemetic approaches for multi-day chemotherapy.
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  • The study investigated the feasibility and effectiveness of a modified behavioral activation program aimed at helping individuals who have lost loved ones to cancer, specifically in reducing depressive symptoms.
  • The program included a series of pre-interviews and seven 50-minute sessions, with participants showing high completion rates of 95% for the intervention and 90% for follow-up.
  • Results indicated significant reductions in depression and anxiety symptoms, with large effect sizes measured three months post-intervention, suggesting that the program effectively supports bereaved individuals.
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Aim: Spouses experience conflicting emotions when caring for partners with severe mental illnesses. They can have negative emotions while also regarding caregiving as positive and may develop a better marital relationship through the caregiving process. This study investigated factors affecting the negative and positive emotions of husbands and wives acting as caregivers of their spouses with severe mental illnesses.

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  • Palonosetron is a second-generation anti-nausea drug that might be more effective than first-generation medications, and this study explores how dexamethasone (DEX) works with it during chemotherapy.
  • Researchers compared the effects of giving DEX for 1 day versus 3 days in preventing nausea and vomiting after moderately emetogenic chemotherapy (MEC), using data from studies published between 1990 and 2020.
  • The findings showed that while the 3-day DEX group had a higher rate of no vomiting, there were no major differences in most anti-nausea effects, suggesting that DEX treatment could be shortened to just 1 day when paired with palonosetron.
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Article Synopsis
  • - The study focuses on the effectiveness and safety of dexamethasone-sparing antiemetic therapies, particularly neurokinin-1 antagonists (NKRA), for preventing chemotherapy-induced nausea and vomiting (CINV) in patients undergoing highly emetogenic chemotherapy (HEC).
  • - A systematic review of literature identified and analyzed two studies involving anthracycline-cyclophosphamide and cisplatin-based regimens; while no significant differences in vomiting prevention were found, some outcomes related to nausea showed variability.
  • - The review concludes that dexamethasone-sparing antiemetic therapies can be effective in preventing CINV for HEC, particularly in patients receiving anthracycline-cyclophosphamide
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Article Synopsis
  • Chemotherapy-induced nausea and vomiting (CINV) negatively impacts patient quality of life, leading to a study that evaluated the effectiveness of adding neurokinin-1 receptor antagonists (NK1RAs) to existing antiemetic treatments for patients undergoing moderately emetogenic chemotherapy (MEC).
  • A systematic review of clinical studies identified 15 randomized controlled trials involving over 4,400 patients, revealing that triplet antiemetic regimens including NK1RAs significantly improved complete response and complete control of nausea compared to doublet regimens, without increasing adverse events.
  • While the addition of NK1RA shows promise for enhancing antiemetic efficacy in carboplatin-based chemotherapy, further research is needed
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Fear of cancer recurrence (FCR) is a common and distressing condition among adolescents and young adults (AYAs). This study aims to investigate the efficacy of digital interventions, including distress screening-based information provision and smartphone problem-solving therapy, on common psychological distress, especially FCR, in AYA patients with cancer. Participants will be 224 AYA outpatients with cancer aged 15-39 years who will be randomly assigned to either an 8-week smartphone-based intervention or a waitlist control group.

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Context: Home palliative care service increases the chance of dying at home, particularly for patients with advanced cancer, but late referrals to home palliative care services still exist. Indicators for evaluating programs that can facilitate the integration of oncology and home palliative care have not been defined.

Objectives: This study developed quality indicators for the integration of oncology and home palliative care in Japan.

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Background: Prolonged grief disorder (PGD) is a new diagnostic entity. However, treatment for PGD is not yet available. Interpersonal psychotherapy (IPT) may be effective for PGD.

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Aim: Patients' and spouses' neurodevelopmental traits may influence marital relationships, which are significantly associated with depressive symptoms. However, no studies have examined marital relationships in persistent depressive disorder (PDD) in terms of neurodevelopmental traits. This study aimed to explore the association between the autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) traits of female PDD patients and both partners' (patient and husband) marital satisfaction.

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Article Synopsis
  • The study aimed to explore the relationship between patients' unrealistic expectations of chemotherapy as a cure and their understanding of being informed about the incurability of their cancer.
  • Researchers analyzed data from 200 patients with non-small cell lung cancer and found that while most oncologists believed they communicated incurability, many patients did not perceive this disclosure.
  • Patients who maintained unrealistic expectations about chemotherapy were less likely to receive specialized palliative care, indicating a link between understanding their prognosis and the care they received.
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  • - The Japan Society of Clinical Oncology updated its 2023 Clinical Practice Guidelines for Antiemesis to incorporate recent findings on antiemetics and cancer treatments, reflecting the latest advancements in the field
  • - A thorough literature search from 1990 to 2020 was conducted to guide the update, leading to the development of 13 background questions, 12 clinical questions, and three future research questions
  • - The updated guidelines aim to enhance understanding and decision-making about antiemetic therapy for both patients and healthcare providers
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Article Synopsis
  • The study evaluated the effectiveness of non-drug therapies for managing anticipatory chemotherapy-induced nausea and vomiting (CINV) in cancer patients, focusing on the impact of past chemotherapy experiences.
  • Out of 107 studies reviewed, six were suitable for inclusion, highlighting three key non-pharmacologic treatments: systematic desensitization, hypnotherapy, and yoga therapy; systematic desensitization showed significant positive results in reducing nausea and vomiting.
  • Despite promising findings for systematic desensitization, concerns about study quality and inconsistent reporting of side effects indicate a need for more rigorous research before these methods are widely adopted in clinical practice.
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Importance: Although the cognitive components of behavioral therapy for overactive bladder (OAB) are widely recognized, there is a lack of studies evaluating the effectiveness of multicomponent interventions that include cognitive components as a treatment for OAB.

Objective: To examine the efficacy of a multicomponent intervention in improving health-related quality of life (HRQOL) for women with moderate to severe OAB.

Design, Setting, And Participants: This multicenter, open-label, randomized clinical trial was conducted in Japan among women aged 20 to 80 years who had moderate to severe OAB.

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Article Synopsis
  • * This study implemented a randomized trial involving 359 cancer patients to evaluate the effectiveness of a smartphone app that included various cognitive-behavioral therapy (CBT) skills alongside psychoeducation over eight weeks, using the PHQ-9 questionnaire to measure outcomes.
  • * Results indicated a significant overall reduction in depressive symptoms among participants, but no specific CBT skill showed added benefit over general psychoeducation, leading to the conclusion that specific recommendations for smartphone psychotherapy components cannot be made based on this study.
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Most patients with advanced cancer initially express a desire to be informed of their prognosis, and prognostic discussions between patients and their oncologists can trigger the subsequent trajectory of prognostic cognitions. On the continuum of prognostic cognition, including inaccurate/accurate prognostic awareness (awareness of incurability of cancer, terminal nature of illness or life expectancy) and prognostic acceptance (accepting one's prognosis), patients' perceptions of being informed of their prognosis by oncologists and patients' coping strategy for serious medical conditions regulate prognostic cognitions. However, nearly half of the patients with advanced cancer have poor prognostic awareness, and few patients achieve prognostic acceptance.

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Purpose: Delirium is a common and serious comorbidity in patients with advanced cancer, necessitating effective management. Nonetheless, effective drugs for managing agitated delirium in patients with advanced cancer remain unclear in real-world settings. Thus, the present study aimed to explore an effective pharmacotherapy for this condition.

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Background: End-of-life discussions for patients with advanced cancer are internationally recommended to ensure consistency of end-of-life care with patients' values. This study examined the elements of end-of-life discussions associated with end-of-life care.

Materials And Methods: We performed a prospective observational study among consecutive patients with pretreated non-small cell lung cancer after the failure of first-line chemotherapy.

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Postoperative delirium is an important issue in cancer patients, affecting surgical outcomes and the quality of life. Ramelteon is a melatonin receptor agonist with high affinity for MT1 and MT2 receptors. Clinical trials and observational studies in Japan, including in surgical cancer patients, have shown efficacy of ramelteon in delirium prevention, with no serious safety concerns.

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Background: Cancer patients experience various forms of psychological distress. Their distress, mainly in the form of depression and anxiety, leads to poor quality of life, increased medical spending due to frequent visits, and decrease in treatment adherence. It is estimated that 30-50% among them would require support from mental health professionals: in reality, much less actually receive such support partly due to a shortage of qualified professionals and also due to psychological barriers in seeking such help.

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Background: Burnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported.

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