暂无摘要。

OBJECTIVE: Hiccups can be bothersome and spawn morbidity. Although oral baclofen is perhaps the most prescribed agent for hiccups, a paucity of data supports its use.
METHODS: This multisite, single institution study examined the medical records of patients who had hiccups and had been prescribed baclofenas noted in a clinical encounter. Mixed methods were used to assess baclofen\'s palliative efficacy. In view of the sometimes transient nature of hiccups and other such factors, cessation or palliation of hiccups in 75% of patients was sought to indicate true palliation.
RESULTS: A total of 301 patients with a median age of 61 years (range 20-87 years) and a male predominance are the focus of this report. Baclofen was most often prescribed at 10 mg orally three times a day. Only 105 patients (35%) (95% CI: 30% to 41%) acquired hiccup palliation. Corroborative medical record quotations included, \'Still has hiccups.\'Quotations such as, \'Responding to baclofen this AM\', were also recorded. Baclofen appeared more likely to benefit patients with hiccups of >48 hours (chronic) duration in univariable analyses (OR for benefit: 0.51 (95% CI: 0.29 to 0.91; p=0.02) with similar conclusions drawn from multivariable analyses. Adverse events occurred in 15 patients with drowsiness the most common.
CONCLUSIONS: Baclofen did not meet this study\'s a priori threshold for successful hiccup palliation, but further study is indicated to learn whether baclofen might help patients with chronic hiccups.

OBJECTIVE: Chemotherapy can cause hiccups but few randomized controlled trials have focused on hiccups. This trial examined the feasibility of such research.
METHODS: This single-institution, multi-site trial used phone recruitment for patients: (1) 18 years or older, (2) able to speak/read English, (3) with a working e-mail address, (4) with hiccups 4 weeks prior to contact, and (5) with ongoing oxaliplatin or cisplatin chemotherapy. The primary outcome was feasibility. Patients were randomly assigned to one of two sets of educational materials, each of which discussed hiccups and palliative options. The experimental materials were almost identical to the standard materials but provided updated content based on the published medical literature. At 2 weeks, patients responded by phone to a 5-item verbally administered questionnaire.
RESULTS: This trial achieved its primary endpoint of recruiting 20 eligible patients within 5 months; 50 patients were recruited in 3 months. Among the 40 patients who completed the follow-up questionnaire, no statistically significant differences between arms were observed in hiccup incidence since initial contact, time spent reviewing the educational materials, and the troubling nature of hiccups. Twenty-five patients tried palliative interventions (13 in the experimental arm and 12 in the standard arm), most commonly drinking water or holding one\'s breath. Eleven and 10 patients, respectively, described hiccup relief after such an intervention.
CONCLUSIONS: Clinical trials for chemotherapy-induced hiccups are feasible and could address an unmet need.

暂无摘要。

OBJECTIVE: We postulated that repetitive peripheral magnetic stimulation (rPMS) might treat idiopathic persistent hiccups. This study aimed to determine the clinical effect of rPMS on hiccup alleviation.
METHODS: Seven patients with idiopathic persistent hiccups experienced the cervical rPMS session (1 Hz, 656 stimuli) in this prospective clinical series from November 2018 to May 2021. The rPMS session was applied once daily until the hiccups were utterly relieved. During the treatment, the round coil was transversally positioned over the upper nape area, and the center of the coil was placed at the level of the C4 vertebrae. The subjective assessment scale (SAS) scores and the hiccup frequency were assessed before and after rPMS treatment.
RESULTS: A total of 7 patients were enrolled. All were male post-stroke patients ([mean ± SD] age, 58.5 ± 9.85 years) with dysphasia, 3 patients (3/7) were fed with a nasogastric tube, and 4 patients (4/7) were with dysarthria. The mean duration of hiccups was 4.14 ± 3.63 days (range 2-12 days). The rPMS therapy eliminated hiccups in all 7 patients. The mean sessions which stopped hiccupping were 3.43 ± 2.57 (range 1-9). The mean value of the SAS scores before rPMS therapy was 7 ± 1 (range 6-8), and it was decreased to zero after the therapy (0). No recurrence of hiccups was observed within 2 weeks of the last rPMS session. rPMS therapies were not associated with severe adverse effects.
CONCLUSIONS: The cervical rPMS therapy is beneficial in treating idiopathic persistent hiccups, particularly in post-stroke patients.

BACKGROUND: To our knowledge, previous studies have not investigated hiccups in patients with cancer with detailed patient-level data with the goal of capturing a broad spectrum of hiccup symptomatology.
METHODS: This multi-site, single institution study examined consecutive medical records to better understand hiccups in patients with cancer.
RESULTS: A total of 320 patients are the focus of this report. The median age of patients when hiccups were first reported in the medical record was 63 years (range: 21, 97 years) with 284 (89%) men and 36 (11%) women. The most common diagnose was gastrointestinal cancer. Hiccups most frequently occurred daily, as seen in 194 patients (62%), and the most common duration was less than 1 week, as seen in 146 patients (47%). However, nine patients had had daily hiccups for greater than 6 weeks, and 5 had symptoms for years. Cited etiology was non-chemotherapy medications in 36 (11%) and cancer chemotherapy in 19 (6%). Complications occurred in approximately a third and included insomnia in 51 patients (16%); hospitalization or emergency department visit in 34 (11%); and musculoskeletal pain in 23 (7%). Baclofen was the single most prescribed agent for hiccup palliation, but 100 patients received more than one medication. Medical procedures, which included acupuncture, paracentesis, or phrenic nerve block, were performed in 5 patients. In 234 patients (73%), the medical record documented hiccup cessation.
CONCLUSIONS: Hiccups appear to be highly problematic in a small subset of patients with cancer with no well-defined palliative approaches.

BACKGROUND: Several case reports suggest that olanzapine palliates hiccups. To our knowledge, however, no larger scale studies have confirmed that olanzapine prevents or palliatives hiccups. Hence, the current study sought to substantiate the conclusions from these earlier case reports.
METHODS: This multi-site single institution study focused on cisplatin-treated cancer patients because this chemotherapy agent is associated with hiccups and because olanzapine is often used as an antiemetic with this agent. Relevant data were extracted from medical records. Hiccup incidence shortly after chemotherapy was compared between olanzapine exposed and non-exposed patients. Other relevant variables were also assessed descriptively in an exploratory manner.
RESULTS: A total of 338 patients were studied. One hundred forty-one had received olanzapine and 197 had not. Twenty-one (6%) developed hiccups. Eleven (8%) of these patients with hiccups had received olanzapine, and 10 (5%) had not [odds ratio (OR): 1.58; 95% confidence interval (CI): 0.65-3.83; P=0.31]. Of note, hiccups were more often observed in men 17 of 188 (9%) than in women 4 of 150 (3%) (OR: 3.64; 95% CI: 1.20-11.02; P=0.01).
CONCLUSIONS: Despite previous case reports and despite the relatively low incidence of hiccups in this study, it does not appear olanzapine prevents or palliates hiccups. The study of other promising agents is warranted. Furthermore, this study invites caution in relying on single case reports in making clinical decisions.

OBJECTIVE: Dexamethasone causes hiccups in an undefined percentage of patients, and these hiccups are often ignored (\'My doctors just shook their heads like I was joking …\'). This study sought to learn the percentage of dexamethasone-treated patients who develop hiccups and to explore patients\' responses to the availability of educational materials on hiccups.
METHODS: English-speaking, adult outpatients treated with oral, intravenous or epidural dexamethasone 2 weeks prior were contacted by phone and asked about hiccups. Educational materials were offered, and patients were queried on their opinion of the availability of such materials.
RESULTS: One hundred and twenty-seven patients or 11% (95% CI 9% to 13%) reported hiccups. This percentage was derived from 1186 reachable patients from 2000 total patients. Fifty-four (43%) of those with hiccups desired to learn about educational materials. Of these, 49 completed a single-item, 5-point scale item: 21 (43%) viewed the availability of educational materials \'extremely helpful,\' providing a 5 rating; 8 (16%) provided a 4; 4 (8%) provided a 3; and 1 (4%) provided a 2.
CONCLUSIONS: Dexamethasone-induced hiccups occur in a small percentage of patients. The fact that most patients responded favourably to learning about the availability of educational materials suggests some have unmet needs.

OBJECTIVE: The aims of this study were to examine the prevalence of myoclonus, sweating, pruritus, hiccup, and vesical and rectal tenesmus, and to explore associated factors in patients with advanced cancer.
METHODS: This multicenter prospective cohort study was conducted in 23 inpatient hospices/palliative care units in Japan from January to December 2017. The prevalence and characteristics of each symptom were assessed on admission and in the 3 days before death. We selected factors that might influence the occurrence of each symptom and investigated the association.
RESULTS: A total of 1896 patients were enrolled. The prevalence of orphan symptoms rose from admission to the 3 days before death: myoclonus 1.3 to 5.3% (95% CI 0.9-1.9%/4.3-6.5%), sweating 1.8 to 4.1% (95% CI 1.3-2.6%/3.1-5.1%), hiccup 1.1 to 1.8% (95% CI 0.7-1.7%/1.2-2.6%), and tenesmus 0.7 to 0.9% (0.4-1.2%/0.5-1.5%). Prevalence of pruritus fell from 3.5 to 2.5% (95% CI 2.7-4.4%/1.8-3.4%). Sweating, pruritus, and hiccups persisted throughout the day in nearly half of the patients. Myoclonus was significantly associated with brain tumors, sweating with opioids and antipsychotics, pruritus with liver and biliary tract cancer, cholestasis and severe diabetes, hiccup with male gender, digestive tract obstruction, severe diabetes, and renal failure. Vesical tenesmus was associated with urinary cancer, antipsychotics, and anticholinergics and rectal tenesmus with pelvic cavity cancer.
CONCLUSIONS: We found that orphan symptoms occurred in 0.5-5.0% of patients, increased over time except for pruritus, and persisted in half of the patients.

Hiccups are a symptom in cancer patients but it\'s less researched.
The aimed to determine of prevalence of hiccups and treatment approach used in hiccup management in cancer patients receiving chemotherapy for nursing care.
This study used a descriptive cross-sectional design with self-reported questionnaires and was conducted from November 2018-May 2019 in Turkey. For collection of the data, a Patient Information Form (sociodemographic and disease characteristics), and a Hiccups Evaluation Form were used for the patients.
Hiccups were observed in 37 (23%) of the 160 patients who met the criteria for inclusion in the study. The great majority of the patients suffering from hiccups were male (65.9%) and the type of cancer in the majority of these patients was gastrointestinal cancer (54.1%). It was determined that the duration of hiccups in 83.8% of patients observed with hiccups was between 0 and 48 hours, that the average severity of their hiccups was 3.81 ± 2.25 (0-10), and that hiccups in 59.5% of these patients was of low severity. It was found that only 10.8% of patients suffering from hiccups used pharmacological methods for relief and that 27% used nonpharmacological methods.
The results of the study showed that over one-fifth of cancer patients suffered from hiccups. This situation reveals that hiccups are an important symptom that needs to be carefully emphasised in oncology practice.