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Advance care planning (ACP) is important to determine the wishes of patients before they lose decision-making capacity. However, Japanese people are often reluctant to have end-of-life discussions. This study aims to develop and categorize an end-of-life preference list in the Japanese context to encourage dialog about ACP for healthcare providers and patients. A questionnaire was developed with end-of-life choices prioritized by a sample of Japanese subjects. Data were collected either in person or by mail. The list of Japanese preferences was compiled and categorized into four domains: medical care, life and care, relationships, and values, with 11-12 items in each domain. The highest-ranking items chosen by >70% of participants were in the relationships and values domains. Subjects with two cohabitants tended to be biased toward the "with others" group, focused on spending time with others, whereas those with older age and higher clinical frailty scale scores tended to be biased toward the "how to live" group.
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http://dx.doi.org/10.1097/NHH.0000000000001213 | DOI Listing |
Support Care Cancer
September 2025
Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
Purpose: To clarify the preferred timing and contents of early palliative care and preference for continued care delivery among patients with advanced cancer in Japan.
Methods: We conducted an Internet-based anonymous questionnaire survey on adult patients with advanced cancer. We assessed the patients' wishes for palliative care delivered by a team or at outpatient clinics while asymptomatic, as well as the preferred intervention timing and preference for continuing care lifelong.
JTCVS Open
August 2025
Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.
Objective: Valve selection in acute type A aortic dissection (ATAAD) requiring aortic root replacement is challenging given the clinical acuity, unknown patient preferences, risk of surgical bleeding, and limited life expectancy. We sought to identify long-term outcomes of mechanical versus bioprosthetic aortic root replacement in young patients with ATAAD.
Methods: Retrospective review of our institution's database of ATAAD was conducted to identify patients aged 65 years and younger who underwent mechanical Bentall (mech-Bentall) or bioprosthetic Bentall (bio-Bentall) for ATAAD from 2002 to 2022.
J Hosp Palliat Care
September 2025
Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Home-based palliative care (HBPC) has emerged as a critical model to address the complex needs of individuals with life-limiting illnesses, particularly in super-aged societies. This review explored the key components of HBPC and elaborated on its benefits, challenges, opportunities, and future directions, drawing on international evidence and practical frameworks. HBPC is reported to enhance the quality of life, reduce unnecessary hospitalizations, and increase the likelihood of patients dying in their preferred settings.
View Article and Find Full Text PDFTranspl Int
September 2025
Unit for Heart Failure and Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Cytomegalovirus (CMV) infection poses significant challenges in solid organ transplant (SOT) recipients, impacting graft outcomes, morbidity, and in some cases survival. The ESOT CMV Workshop 2023 convened European experts to discuss current practices and advances in the management of CMV with the aim of improving the quality of life of transplant recipients. Discussions covered crucial areas such as preventive strategies, diagnostic challenges, therapeutic approaches, and the role of cell-mediated immunity (CMI) monitoring.
View Article and Find Full Text PDFClin Genitourin Cancer
August 2025
Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
Background: Combination therapy with enfortumab vedotin plus pembrolizumab (EV+P) is now the preferred first-line (1L) therapy for advanced urothelial carcinoma (aUC), but prognostic indicators for patients on 1L EV+P have not yet been described.
Patients And Methods: We conducted a retrospective cohort study of patients receiving 1L EV+P for aUC. We analyzed deidentified electronic health record data from the Flatiron Health database to identify adults with aUC who initiated EV+P between April 3, 2023 and December 31, 2024.