Nausea Scores Research Articles

Effects of endurance exercise under hypoxic conditions on the gastric emptying rate and intestinal cell damage.

The present study examined the effects of gastric emptying rate and intestinal cell damage following a single session of endurance exercise under "hypoxic" or "normoxic" conditions at the same relative intensity. Eleven healthy males performed two trials on different days, consisting of a 60min run on a treadmill at 70% maximal running velocity (vMax) while inspiring hypoxic (FiO2: 14.5%; HYP) or normoxic air (FiO2: 20.9%; NOR). The average running velocity was 11.4 ± 0.7km/h in NOR and 10.8 ± 0.5km/h in HYP, respectively. Venous blood samples were collected to evaluate plasma intestinal fatty acid binding protein (I-FABP) as an indicator of exercise-induced intestinal cell damage. The gastric emptying rate was determined by the 13C-sodium acetate breath test. Running velocities at 70% vMax and arterial oxygen saturation were significantly lower under HYP than NOR (p < 0.001). Peak heart rate and rating of perceived exertion during exercise did not differ significantly between the trials. Maximum 13C excretion time (an indication of the gastric emptying rate) was significantly delayed in the HYP (NOR: 38.5 ± 5.0min, HYP: 45.5 ± 9.6min; p = 0.010). Furthermore, the score of nausea increased slightly, but increased significantly after exercise only in the HYP (p = 0.04). However, exercise-induced changes in plasma I-FABP, adrenaline, and noradrenaline concentrations did not differ significantly between the two trials. These results suggest that endurance exercise under hypoxic conditions impairs digestive function in the stomach compared to exercise under normoxic conditions performed at the same relative intensity.

A nationwide double-blind phase III randomized clinical trial (RCT) of olanzapine vs. prochlorperazine for the treatment of refractory nausea in patients receiving moderately or highly emetogenic chemotherapy among NCI Community Oncology Research Program (NCORP) practices.

185 Background: Despite advances in antiemetics given during chemotherapy, nausea remains a clinically significant issue and greatly impairs quality of life (QOL). Current ASCO guidelines recommend olanzapine or prochlorperazine for refractory chemotherapy-induced nausea. However, there is a lack of direct empirical comparisons to establish their relative efficacy. Methods: The URCC NCORP Research Base and 21 NCORP practices enrolled 1,363 chemotherapy-naïve patients with breast cancer starting a high/moderate emetogenic chemotherapy regimen to this Phase III RCT (NCT03367572). Antiemetics were prescribed per ASCO guidelines. Screening occurred during Cycle 1, followed by randomization for Cycle 2. Those with ≥ moderate nausea (≥3 on a 1-7 scale) in Cycle 1 and willing to continue were randomized (1:1:1 ratio) into 3 arms (n=310): 1) ASCO regimen plus olanzapine (OLZ), 2) ASCO regimen plus prochlorperazine (PC), or 3) ASCO regimen plus placebo. Nausea was evaluated using a four-day home diary (4x daily), with the primary outcomes being changes in average (avg) and maximum (max) nausea. FACT-G measured QOL. Intent-to-treat primary analyses (ANOVA and Cohen’s Δ effect size) evaluated whether OLZ or PC improved nausea, testing between-arm differences in nausea change from Cycle 1 to 2 compared to placebo at a p=0.025 significance level corrected for 3 arms. Results: The median age was 50.7y, with 80.7% White/12.3% Black/5.8% Asian/4.2% Latino, and evenly distributed across groups. The change in avg nausea score was statistically significant for the OLZ (avg change = −1.07: Cohen’s Δ = 0.49) and PC arms (avg change = −0.94: Cohen’s Δ = 0.38) compared to the placebo (avg change = −0.50; p &lt;0.001 vs OLZ, p = 0.01 vs PC). Similar but larger changes were noted for change in max nausea score in the OLZ (max change = −2.57: Cohen’s Δ = 0.86) and PC arms (max change = −2.01: Cohen’s Δ = 0.47) against the placebo (max change = −1.30; p &lt;0.001 vs OLZ, p &lt;0.01 vs PC). The OLZ arm had a clinically significant change in overall QOL from pre-chemo to Cycle 2 vs placebo (FACT-G mean difference = +4.91; p = 0.006) but the PC arm vs placebo did not (FACT-G mean difference = −0.87; p = 0.61). OLZ exhibited superiority over PC in terms of changes in max nausea (mean difference = −0.56; p = 0.023) and QOL (FACT-G mean difference = +5.80; p = 0.006), but not for avg nausea (mean difference = −0.13; p = 0.418). Conclusions: OLZ and PC, when added to ASCO guidelines, each significantly reduces refractory nausea. OLZ demonstrates superior max nausea control with clinically and statistically significant improvements in QOL. This study fills the gap in empirical comparisons and solidifies OLZ's position as a promising intervention for refractory nausea. Clinical trial information: NCT03367572 .

Comparison of Efficacy and Safety of Prophylactic Use of Metoclopramide and Haloperidol on Morphine-induced Nausea and Vomiting in Cancer Patients: A Comparative, Randomised, Prospective Study

Objectives: Morphine is the cornerstone of pain management in a palliative care setting. Nausea with or without vomiting usually occurs when patients are initiated on morphine for the 1st time or when the dose is substantially increased. Materials and Methods: A total of 90 patients fulfilling the inclusion criteria were randomly allocated into two groups of 45 each. Group M received a tablet of metoclopramide 10 mg orally 3 times a day; Group H received a tablet of haloperidol (2.5 mg) orally at night. All the patients were provided NCI CTCAE V4.3 NAUSEA AND VOMITING SCALE and asked to mark their response from day 1 to day 7. At the follow-up visit on the 7th day, the form was collected, and data were analysed. Results: In Group M and Group H, the mean nausea score was between 1 and 2 and the difference was statistically insignificant. In Group M, the maximum vomiting score was 1.28 on day 5, while in Group H, the maximum score was 2 on day 5. The difference between the two groups was statistically significant. Conclusion: Metoclopramide and haloperidol are equally efficacious in preventing nausea, but metoclopramide was found to be more effective with lesser side effects than haloperidol for morphine-induced vomiting in cancer patients when used prophylactically.

Penerapan Pijat Akupresur pada Ibu Hamil Trimester I untuk Mengatasi Masalah Emesis Gravidarum di Wilayah Kerja Puskesmas Putri Ayu Kota Jambi

Nausea and vomiting or emesis gravidarum are the most common discomforts in the first trimester of pregnancy. If nausea and vomiting are not treated immediately, the body will become weak, dehydrated and have a pale face. Based on the results of the study, Mrs. D, 32 years old, first trimester of pregnancy with the main complaint of nausea and vomiting. One way to reduce nausea and vomiting is with acupressure massage techniques. Acupressure massage is done by gently pressing the PC 6 point for 2 minutes, the aim of which is to have an effect on giving acupressure massage to pregnant women in the first trimester to overcome the problem of emesis gravidarum. The method used is a case study with data collection techniques through observation, interviews and physical examination with the superior intervention of acupressure massage to reduce emesis gravidarum or nausea and vomiting. The results showed that there was a diagnosis of nausea with the intervention of giving acupressure massage for 3 days. The results showed that after the acupressure massage there was a decrease in the Pregnancy Unique Quantification of Emesis and/or Nausea (PUQE) score on the first day of the intervention with a score of 8 (moderate nausea and vomiting category) after the day all three interventions with a score of 3 (mild nausea and vomiting category). Conclusion: Application of acupressure massage can reduce emesis gravidarum or nausea and vomiting in first trimester pregnant women.

Training of spatial cognitive abilities reduces symptoms of visually induced motion sickness.

This study aims to explore the effectiveness of enhancing individual spatial cognitive abilities in alleviating the negative symptoms of visually induced motion sickness (VIMS). Additionally, it seeks to develop innovative intervention methods to improve spatial cognition and identify new treatment approaches for VIMS. The study investigated the impact of innovative interventions on spatial cognitive abilities and their modulation of VIMS susceptibility. A total of 43 participants were recruited (23 in the experimental group and 20 in the control group). The experimental group underwent six sessions of spatial cognitive ability training, while the control group engaged in activities unrelated to spatial cognition. The analysis revealed that the spatial cognitive ability scores of the experimental group significantly improved after the intervention. Furthermore, the experimental group exhibited significant differences in nausea, oculomotor, disorientation, and total SSQ scores before and after the intervention, indicating that the intervention effectively mitigated VIMS symptoms. This study developed a virtual reality training method that effectively enhances individual spatial cognitive abilities and significantly alleviates VIMS symptoms, providing a novel and effective approach for VIMS intervention and treatment.

The Role of hCG and Histamine in Emesis Gravidarum and Use of a Chewing Gum Containing Vitamin C as a Treatment Option: A Double-Blinded, Randomized, Controlled Trial.

Background: Nausea and vomiting in pregnancy (NVP), or emesis gravidarum, is a frequent complication of early gestation with unclear causes, suspected to involve genetic, hormonal, and gastrointestinal factors. Our study investigated the association of human chorionic gonadotropin (hCG), histamine, diamine oxidase (DAO), thyroxine and pyridoxine and the severity of NVP symptoms and assessed the efficacy of a vitamin C-containing chewing gum as a potential NVP treatment. Methods: In this prospective, double-blinded, randomized, controlled trial, 111 participants were assigned to receive vitamin C-containing chewing gum, placebo gum, or no treatment at two follow-ups during early pregnancy. Maternal serum levels of hCG, histamine, DAO, thyroxine, and pyridoxine were measured and correlated with NVP severity using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24) score. Results: Elevated maternal hCG levels were significantly associated with an increased PUQE-24 score (p < 0.001), while histamine levels showed no significant correlation (p = 0.68). Maternal DAO levels negatively correlated with NVP symptoms (p < 0.001) and elevated thyroxine (p < 0.001) and pyridoxine levels (p < 0.001) were associated with increased PUQE-24 scores. The vitamin C-containing chewing gum did not demonstrate efficacy in alleviating NVP symptoms compared to placebo gum or no treatment during the first (p = 0.62) and second follow-up visits (p = 0.87). Conclusions: Our study underscores the complexity of factors contributing to NVP, highlighting the significant roles of hCG and DAO, while histamine levels appear unrelated. Maternal thyroxine and pyridoxine levels also significantly correlate with NVP symptoms. Vitamin C-containing chewing gum was not effective as a treatment for NVP. Further large-scale studies are needed to better understand these interactions and develop targeted treatments in the future.

Suicidal Ideation was Associated with Quality of Life Impairment of Patients with Lung Cancer: A Cross-Sectional Study in Vietnam.

This study aimed to measure the quality of life (QOL) of lung cancer patients and evaluate the relationship between QOL and suicidal ideation (SI) in a tertiary hospital in Vietnam. A cross-sectional study was conducted at Bach Mai Hospital in Hanoi, Vietnam. A total of 256 patients with lung cancer were recruited. The QOL of cancer patients was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) version 3. Multivariate Tobit regression was employed to identify associations between SI and QOL. Overall, the mean global health status score was 58.3 ± 15.8, and those with SI had significantly higher scores than those without SI. Regarding functional scales, patients with SI had significantly lower physical functioning (82.22 ± 11.42) compared to those without SI (90.58 ± 11.90) (p<0.05). Meanwhile, regarding symptom scales, scores for fatigue, nausea and vomiting, pain, insomnia, appetite loss, constipation, diarrhea, and financial difficulties among patients with SI were significantly higher than those without SI (p<0.05). In the multivariate analysis, having SI increased the role functioning score (Coef. = 9.41, 95% CI = 0.38-18.45) and diarrhea score (Coef. = 22.33, 95% CI = 2.05-42.60). This study indicated moderate QOL and perceived the lowest social functioning in lung cancer patients. SI was associated with role functioning scores and diarrhea scores. SI should be monitored and controlled regularly in this population during treatment to improve their QOL.

Comparison of predictive models in postoperative nausea and vomiting in patients undergoing breast cancer surgery

BackgroundPost-operative nausea and vomiting remain an unresolved concern in Türkiye and some parts of the world, impacting the quality of the patient's recovery process and diminishing overall satisfaction.ObjectiveThis study was conducted as a descriptive investigation to compare the incidence of nausea and vomiting following breast cancer surgery with the nausea and vomiting risk scores proposed by Apfel and Koivuranta.MethodsThis study was conducted with 100 patients admitted to the General Surgery service of a university hospital between 31 August 2019 and 31 May 2021 for breast cancer surgery. The patient information form developed by the researchers, Apfel Nausea and Vomiting Risk Score, and Koivuranta Nausea and Vomiting Risk Score were used as data collection tools.ResultsIt was identified that 61% of the patients experienced nausea and vomiting within the initial 24 h following surgery. A significant correlation was found between age, post-operative opioid use, motion sickness or history of PONV, and nausea and vomiting (p < 0,05). The sensitivity of the Apfel score obtained was 80%, the specificity was 46%, and the AUC value was 0.686. The sensitivity of the Koivuranta score was 80%, the specificity was 35%, and the AUC value was 0.675 (p < 0.05).ConclusionIt has been observed that patients experience high rates of nausea and vomiting after breast cancer surgery and that the Apfel and Koivuranta Risk Scores are equally applicable in predicting post-operative nausea and vomiting.

Comparison of intravenous and periarticular administration of dexamethasone in total knee arthroplasty

PurposeCorticosteroids are widely used in total knee arthroplasty (TKA) to ameliorate post-operative pain. This study compared the effects of intravenous administration (IVA) and periarticular injection (PAI) of dexamethasone on pain, nausea, and blood glucose levels following TKA. MethodsAn institutional database was used to retrospectively examine two cohorts of patients who had undergone unilateral TKA from August 2018 to September 2020. The IVA group (n ​= ​50) received 10 ​mg dexamethasone 1 ​h before surgery and 24 ​h after surgery. The PAI group (n ​= ​50) received 10 ​mg dexamethasone during surgery. Pain scores at rest and during walking as well as nausea scores were recorded using the 0–10 numerical rating scale after surgery. Fasting blood glucose (FBG) levels were measured post-operatively. ResultsA total of 100 patients were enrolled (mean age, 71 years; 86% female). The rest pain score 24 ​h post-operatively was significantly lower in the PAI group than in the IVA group (3.3 vs. 4.3; absolute difference 1.0, 95% confidence interval, 0.4–1.3; P ​= ​0.007). The nausea score did not differ markedly between groups. FBG was significantly higher in the PAI group than in the IVA group in the morning of post-operative Day 1. ConclusionPAI with dexamethasone was found to control pain more effectively at 24 ​h than IVA. FBG on the morning of post-operative Day 1 was significantly higher in the PAI group. Level of evidence, III; retrospective cohort.

Implementation of a Multimodal Enhanced Recovery Protocol in Ambulatory Anorectal Surgery: A Randomized Trial.

Few studies report outcomes for enhanced recovery pathways in ambulatory anorectal surgery. We hypothesize that an ambulatory anorectal enhanced recovery pathway with multimodal analgesia can reduce postoperative opioid use. To compare postoperative opioid use in patients undergoing ambulatory anorectal surgery who receive multimodal analgesia vs. standard of care without multimodal analgesia. A prospective randomized trial of patients undergoing elective anal fistula or hemorrhoid surgery from September 2018 to May 2022. Urban teaching hospital. Adults aged 18 to 70 undergoing elective anal fistula or hemorrhoid surgery from September 2018 to May 2022. Multimodal enhanced recovery pathway including pre- and postoperative non-opioid analgesia with oral acetaminophen, gabapentin and ketolorac. Primary endpoint was oral opioid use during the first postoperative week. Secondary endpoints included maximum pain and nausea scores, adverse events and emergency room or hospital admissions during the first 30 days postoperatively. Of the 109 enrolled patients, 20 were lost to follow-up. The remaining 89 patients had a median age of 38 (range, 20-67) years and included 41 (46%) females. There were no significant differences between the enhanced recovery protocol (Arm E) and non-enhanced recovery protocol (Arm NE) groups in terms of preoperative and surgical characteristics. The study primary endpoint, oral MME use during the first week, was significantly higher among patients in the NE arm (79 mg; range, 0-600) than patients in the E arm (8 mg; range, 0-390) (p = 0.002). On subgroup analysis, both fistula and hemorrhoid surgery patients assigned to the NE arm took significantly higher oral MME in the first week than patients in the E arm. There was no significant difference in secondary endpoints. Patients and providers were not blinded. Our findings are limited to hemorrhoid and fistula surgery and may not be applicable to other anorectal procedures. Enhanced recovery protocols including multimodal analgesia should be used in elective anal fistula and hemorrhoid surgery to decrease postoperative opioid use. See Video Abstract . ClinicalTrials.gov ID NCT03738904.

Perioperative Dexamethasone Split Between 2 Doses Further Reduced Early Postoperative Nausea and Vomiting Than Single-Dose Dexamethasone: A Randomized Blinded Placebo-Controlled Trial

BackgroundWe investigated whether 2 doses of dexamethasone are more effective than a single dose in reducing early postoperative nausea and vomiting (PONV) during total knee arthroplasty (TKA). MethodsA total of 150 patients between June 2021 and June 2022 were randomized into 3 groups: 2 doses of normal saline (group A), a single dose of 10 mg dexamethasone before surgery and normal saline after surgery (group B), and 2 doses of 5 mg dexamethasone during the perioperative period (group C). Primary outcomes were incidences and severity of PONV within 24 hours after surgery, the number and consumption of patients requiring morphine and metoclopramine, and visual analog scale scores for nausea and vomiting at 2, 4, 6, and 24 hours after surgery. Blood glucose levels on days 1, 2, and 3 after operation and incidences of surgical site infection (SSI) as well as gastrointestinal bleeding (GIB) within 45 days after operation were compared. ResultsWithin 24 hours after operation, the number and consumption of patients requiring morphine and metoclopramide in groups B and C were significantly lower than those in group A. Incidences and severity of PONV in groups B and C were significantly lower than those in group A. And these differences between groups B and C were significant. At 2, 4, 6, and 24 hours after operation, there were significant differences in visual analog scale scores of PONV between groups A and B, A and C, as well as B and C. On postoperative days 1, 2, and 3, there were no significant differences in blood glucose levels among the groups, and there were no incidences of SSI or GIB in any group within 45 days after operation. ConclusionDexamethasone significantly reduces PONV within 24 hours after TKA, does not result in significant changes in postoperative blood glucose levels, and does not increase the risk of SSI or GIB, particularly on group C. Registration numberChiCTR2400088512. Registration centerChinese Clinical Trial Registry (ChiCTR). Websitewww.chictr.org.cn.

Effect of Acupressure Technique with Wristband on Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy Patient

Background: Laparoscopic cholecystectomy is widely recognized as the preferred method for treating gallstone disease. However, like any surgical procedure involving anesthesia, it carries the risk of postoperative complications, including common side effects such as vomiting and nausea. As a result, acupressure treatments targeting the pericardium 6 (P6) point have gained attention in alleviating nausea and vomiting. This non-invasive massage technique has been emphasized by the World Health Organization (WHO) due to its significance.Objectives: The main purpose of this study is to assess the impact of acupressure treatment at the wristband point (P6) on nausea and vomiting experienced by patients undergoing laparoscopic cholecystectomy.Method: A quasi-experimental study was conducted at Safer Al Imam Al Hussein Surgical Hospital in Karbala Holy City. Sixty patients undergoing laparoscopic cholecystectomy were divided into two groups: 30 patients in the intervention group received acupressure techniques using an elastic wristband postoperatively, which was removed after six hours, while 30 patients in the control group received routine conventional care. Descriptive analysis (e.g., frequency, percentage, and mean score) and inferential analysis (e.g., one-way ANOVA test, independent sample t-test) were employed to examine and measure the study outcomes. A p-value of &lt;0.05 was considered statistically significant.Results: The mean score for nausea and vomiting in the intervention group decreased significantly from 1.97 ± 0.183 before the intervention to 1.13 ± 0.354 after implementing the intervention (p-value = 0.000). In contrast, the control group did not experience any improvement in their symptoms, with their condition worsening significantly.Conclusion: Patients experiencing nausea and vomiting after laparoscopic cholecystectomy surgery may benefit from the non-invasive treatment of wristband acupressure.

Perioperative Analgesic Effect of Serratus Anterior Plane Block for Breast Surgery: A Randomized Control Study at a Large Teaching Hospital in Ghana.

Background Pain after breast surgery has been described as moderate to severe in intensity and, if inadequately treated, increases postoperative morbidity, hospital cost, and the incidence of persistent postoperative pain. Serratus anterior plane (SAP) block is an interfascial injection technique for analgesia of the chest wall. There is a lack of data with regard to its analgesic and possible opioid-sparing effects in Sub-Saharan Africa. This study aimed to determine the perioperative analgesic effect of serratus anterior plane block administered for breast surgery. Methods This was a prospective, randomized, double-blinded study involving 52 patients and was randomized into the intervention (n = 26) and control (n = 26) groups. One patient in the control group did not receive the allocated intervention, while one in the intervention group lost to follow-up. Complete data of 50 participants, comprising intervention (n=25), was used in the analysis. Patients' demographic and health characteristics, pre-induction, intra-operative, and postoperative hemodynamic parameters were noted. After induction of anesthesia, a blinded anesthetist performed an ultrasound-guided serratus anterior plane block with 0.25% plain bupivacaine or a sham block using 0.9% normal saline (control). Numerical rating scale (NRS) score and incidence of postoperative nausea and vomiting (PONV) were recorded immediately after surgery and at 1, 4, 8, and 24 postoperative hours. Patient satisfaction with analgesic management within the first 24 postoperative hours was also assessed. Results Patients who received SAP block had lower NRS scores at all measured time points, but this was only statistically significant at the fourthpostoperative hour (p-value= 0.002). Compared to controls, patients who received SAP had lower intraoperative (11.3±1.5 mg vs. 11.9±1.5 mg,p value = 0.131) and postoperative (4.6±5.7mg vs. 10.5±6 mg,p value=0.001) mean opioid consumption. However, only the reduction in postoperative opioid consumption was found to be statistically significant. Most participants (> 90%) in this study did not experience PONV and were very satisfied with their postoperative pain management. Conclusion Serratus anterior plane block reduces NRS pain scores postoperatively. It also significantly reduces postoperative opioid consumption but does not significantly reduce intraoperative opioid consumption.

Neiguan (PC6) acupoint stimulation for preventing chemotherapy-induced nausea and vomiting: a cost-effective supplement in guideline-inconsistent chemotherapy-induced nausea and vomiting prophylaxis subgroup.

To assess the efficacy and safety of Neiguan (PC6) acupoint acustimulation in preventing chemotherapy-induced nausea and vomiting (CINV), especially for patients with guideline-inconsistent CINV prophylaxis (GICP) due to personal reasons METHODS: From January 2021 to December 2021, 373 patients suffered from solid malignancy were recruited according to the inclusion criteria. Complete response (no emesis and no rescue medication use) rate during the overall phase (0-120 h of each chemo-cycle) was the primary assessment of CINV control. The Functional Living Index-Emesis (FLIE) questionnaire was investigated among these patients as a secondary 'quality of life' objective to assess the impact of CINV on patients' daily life by recording score of nausea and vomiting. With acustimulation of Neiguan (PC6) acupuncture point through a portable, noninvasive and user-friendly device, in terms of complete response rate and scores in nausea/vomiting by FLIE questionnaire, patients achieve a better outcome in highly emetogenic chemotherapy (HEC) induced CINV, especially GICP subgroup. Meanwhile, analysis also demonstrated this tendency existed in other patients with HEC/GCCP (guideline consistent CINV prophylaxis) and moderate emetogenic chemotherapy, although the difference was not significant. Considering advantages of Neiguan (PC6) acustimulation such as noninvasive, covered by medical insurance and few side effects, we believe it would be an ideal auxiliary tool in CINV control, especially in patients who receive highly emetogenic chemo-protocol and are reluctant to GCCP for economic reasons.

Establishing a nausea-free ward model to reduce chemotherapy-induced nausea and vomiting: A retrospective study.

The objective of this study was to establish a nausea-free ward model and evaluate the effect of an intervention procedure guided by this model on chemotherapy-induced nausea and vomiting (CINV) in cancer patients. A total of 105 chemotherapy patients from March to September 2022 before the establishment of nausea-free ward in the Chongqing Jiulongpo District People's Hospital were selected as the control group as well as 105 chemotherapy patients from March to September 2023 after the establishment of nausea-free ward as the intervention group. The intervention group was managed by comprehensive standardized CINV management on the basis of the control group. Finally, the Chinese Society of Clinical Oncology grading tool for nausea and vomiting and the Functional Living Index-Emesis were used to evaluate the effect. Under the intervention of the nausea-free ward model, the intervention group exhibited significantly lower ratings of nausea and vomiting compared to the control group (all P-value <.05). The nausea score, vomiting score, and total score of the intervention group were significantly lower than the control group (all P-value <.05). Our study found CINV symptoms and quality of life can be significantly improved by the application of the nausea-free ward model. The nausea-free ward model is instructive in clinical practice and can guide clinical work as well as bring management experience to clinical workers.

The clinical effectiveness of ginger compared to vitamin B6 in reducing hyperemesis gravidarum: Systematic review

Introduction: Hyperemesis gravidarum refers to an extreme condition of nausea and vomiting that occurs during pregnancy. Nausea and vomiting that harm the mother differ from morning sickness, commonly experienced in early trimester pregnant women. Approximately 14.8% of pregnancies experience symptoms of nausea and vomiting, with occurrence rates ranging from 60-80% among first-time mothers (primigravidas) and 40-60% among women who have had multiple pregnancies (multigravidas). These symptoms become more severe in one in a thousand pregnancies. Purpose: This study aimed to systematically review Ginger's effectiveness compared to vitamin B6 in reducing hyperemesis gravidarum. Method: This is a systematic review of three databases (PubMed, ScienceDirect, and Willey online library). The PRISMA-ScR protocol was employed in this research review, utilizing a Population, Intervention, Comparison, and Outcome (PICO) framework. The population is first-trimester pregnant women who experience Hyperemesis gravidarum using a completely original research article comparing Ginger and vitamin B6 in reducing hyperemesis gravidarum. Results: A significant statistical distinction was observed between the Ginger and the vitamin B6 group concerning the nausea score (mean difference 0.63, CI -0.10-1.35) and vomiting score (mean difference 0.42, CI -0.13, 0.98). Conclusion: Based on the research results, there was no significant difference in the effectiveness of giving Ginger compared to vitamin B6 in reducing hyperemesis gravidarum. However, the analysis showed that the average score of giving Ginger was lower than vitamin B6. The lower the nausea or vomiting score, the better the effect of the intervention. Suggestion: Health workers (doctors and midwives) can use Ginger as an alternative to reduce hyperemesis gravidarum during early pregnancy.

Impact of Intraoperative Nefopam on Postoperative Pain, Opioid Use, and Recovery Quality with Parietal Pain Block in Single-Port Robotic Cholecystectomy: A Prospective Randomized Controlled Trial.

Background and Objectives: This study explored how nefopam, a non-opioid analgesic in a multimodal regimen, impacts postoperative pain, opioid use, and recovery quality in single-port robot-assisted laparoscopic cholecystectomy (RALC) patients with a parietal pain block, addressing challenges in postoperative pain management. Materials and Methods: Forty patients scheduled for elective single-port RALC were enrolled and randomized to receive either nefopam or normal saline intravenously. Parietal pain relief was provided through a rectus sheath block (RSB). Postoperative pain was assessed using a numeric rating scale (NRS) in the right upper quadrant (RUQ) of the abdomen, at the umbilicus, and at the shoulder. Opioid consumption and recovery quality, measured using the QoR-15K questionnaire, were also recorded. Results: The 40 patients had a mean age of 48.3 years and an average body mass index (BMI) of 26.2 kg/m2. There were no significant differences in the pre- or intraoperative variables between groups. Patients receiving nefopam reported significantly lower RUQ pain scores compared to the controls, while the umbilicus and shoulder pain scores were similar. Rescue fentanyl requirements were lower in the nefopam group in both the PACU and ward. The QoR-15K questionnaire scores for nausea and vomiting were better in the nefopam group, but the overall recovery quality scores were comparable between the groups. Conclusions: Nefopam reduces RUQ pain and opioid use post-single-port RALC with a parietal pain block without markedly boosting RSB's effect on umbilicus or shoulder pain. It may also better manage postoperative nausea and vomiting, underscoring its role in analgesia strategies for this surgery.

Association of Remote Patient-Reported Outcomes and Step Counts With Hospitalization or Death Among Patients With Advanced Cancer Undergoing Chemotherapy: Secondary Analysis of the PROStep Randomized Trial.

Patients with advanced cancer undergoing chemotherapy experience significant symptoms and declines in functional status, which are associated with poor outcomes. Remote monitoring of patient-reported outcomes (PROs; symptoms) and step counts (functional status) may proactively identify patients at risk of hospitalization or death. The aim of this study is to evaluate the association of (1) longitudinal PROs with step counts and (2) PROs and step counts with hospitalization or death. The PROStep randomized trial enrolled 108 patients with advanced gastrointestinal or lung cancers undergoing cytotoxic chemotherapy at a large academic cancer center. Patients were randomized to weekly text-based monitoring of 8 PROs plus continuous step count monitoring via Fitbit (Google) versus usual care. This preplanned secondary analysis included 57 of 75 patients randomized to the intervention who had PRO and step count data. We analyzed the associations between PROs and mean daily step counts and the associations of PROs and step counts with the composite outcome of hospitalization or death using bootstrapped generalized linear models to account for longitudinal data. Among 57 patients, the mean age was 57 (SD 10.9) years, 24 (42%) were female, 43 (75%) had advanced gastrointestinal cancer, 14 (25%) had advanced lung cancer, and 25 (44%) were hospitalized or died during follow-up. A 1-point weekly increase (on a 32-point scale) in aggregate PRO score was associated with 247 fewer mean daily steps (95% CI -277 to -213; P<.001). PROs most strongly associated with step count decline were patient-reported activity (daily step change -892), nausea score (-677), and constipation score (524). A 1-point weekly increase in aggregate PRO score was associated with 20% greater odds of hospitalization or death (adjusted odds ratio [aOR] 1.2, 95% CI 1.1-1.4; P=.01). PROs most strongly associated with hospitalization or death were pain (aOR 3.2, 95% CI 1.6-6.5; P<.001), decreased activity (aOR 3.2, 95% CI 1.4-7.1; P=.01), dyspnea (aOR 2.6, 95% CI 1.2-5.5; P=.02), and sadness (aOR 2.1, 95% CI 1.1-4.3; P=.03). A decrease in 1000 steps was associated with 16% greater odds of hospitalization or death (aOR 1.2, 95% CI 1.0-1.3; P=.03). Compared with baseline, mean daily step count decreased 7% (n=274 steps), 9% (n=351 steps), and 16% (n=667 steps) in the 3, 2, and 1 weeks before hospitalization or death, respectively. In this secondary analysis of a randomized trial among patients with advanced cancer, higher symptom burden and decreased step count were independently associated with and predictably worsened close to hospitalization or death. Future interventions should leverage longitudinal PRO and step count data to target interventions toward patients at risk for poor outcomes. ClinicalTrials.gov NCT04616768; https://clinicaltrials.gov/study/NCT04616768. RR2-10.1136/bmjopen-2021-054675.

Fire dragon cupping in prevention and treatment of chemotherapy-induced nausea and vomiting in breast cancer: a randomized controlled trial

To observe the clinical efficacy and safety of fire dragon cupping in prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in breast cancer. Sixty breast cancer patients receiving medium-high emetogenic chemotherapy regimen were randomly divided into an observation group (30 cases, 3 cases dropped out) and a control group (30 cases, 3 cases dropped out). In both groups, 5 mg tropisetron hydrochloride was given intravenously on the day of chemotherapy and 1st to 3rd days after chemotherapy. In the observation group, fire dragon cupping on the abdomen was applied on 1st, 3rd and 5th days after chemotherapy. The incidence of nausea, vomiting, loss of appetite, abdominal pain, abdominal distension, the severity of nausea, vomiting on 1st to 6th days after chemotherapy, and the duration of nausea, vomiting, loss of appetite were observed in the two groups. The self-rating anxiety scale (SAS) score, general comfort questionnaire scale (GCQ) score before and after treatment and remedy antiemetic medication were observed in the two groups, and the safety was evaluated. On 2nd to 6th days after chemotherapy, the number of patients with nausea, loss of appetite and abdominal distension and nausea scores in the observation group were lower than those in the control group (P<0.05). On 1st to 3rd days after chemotherapy, the number of patients with vomiting and vomiting scores in the observation group were lower than those in the control group (P<0.05). The duration of nausea, vomiting and loss of appetite in the observation group were shorter than those in the control group (P<0.05). In the observation group, there was no significant difference in SAS and GCQ scores before and after treatment (P>0.05). After treatment, the GCQ score in the control group was decreased compared with that before treatment (P<0.05). After treatment, there was no significant difference in SAS and GCQ scores between the two groups (P>0.05). There was no significant difference in the number of patients using remedy medication between the two groups (P>0.05). No adverse reaction occurred during treatment in both groups. Fire dragon cupping can effectively reduce the incidence of nausea, vomiting, loss of appetite and the severity of nausea, vomiting related to chemotherapy in breast cancer, and improve patient comfort, and have good safety.

HOW DOES MENTAL DISTRACTION INDUCED BY AN ADDITIONAL TASK AFFECT THE SEVERITY OF SIMULATOR SICKNESS SYMPTOMS IN PILOTS: A SPATIAL DISORIENTATION SIMULATOR STUDY

Introduction: To improve the effectiveness of spatial disorientation (SD) training in a flight simulator, pilots are recommended to perform an additional task that induces a mental distraction. The presented study explored how the inclusion of an additional task that may enhance the effectiveness of SD training changes the severity of simulator sickness symptoms reported after exposure in the Gyro-IPT simulator. Methods: We compared the incidence of simulator sickness symptoms in pilots across four setups of flight scenarios (varying according to cognitive load distraction) collected during our previous studies. A total of 77 male military pilots (age 28.3±6.2) with flight experience (810.72 ±969.43 hours) were randomly assigned to one of four groups and then exposed to a 60-min long flight session (12 flight profiles, six involved an SD-conflict) with active control in the Gyro IPT simulator. In addition to the primary flying task, in three flight scenarios, pilots were asked to perform an additional visual (a change detection flicker task [CDFT]), auditory (an auditory N-back task [NBT]), or duration-discrimination task (DDT)). To measure simulator sickness symptoms, the Simulator Sickness Questionnaire (SSQ) was administered pre- and post-simulator exposure. Results: The severity of simulator sickness symptoms due to visual and motion cues did not significantly change when the pilot performed a non-sickening cognitive task (additional visual or auditory task). The total SSQ score and scores for nausea, oculomotor disturbance, and disorientation in the CDFT and DDT were slightly higher than in the control condition (flight without additional task). Despite the observed differences, according to the SSQ scoring criteria, the simulator sickness symptoms reported by the pilots were negligible. Conclusions: The additional tasks (CDFT, auditory NBT, or DDT) applied to improve the effectiveness of SD training in the Gyro-IPT simulator do not significantly change unwanted effects, such as simulator sickness.