Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1251/2021
Hilda Aracely Magaña Guardado
Breast cancer in men is a rare disease, it represents less than 1░% of all male cancers; and almost 1░% of breast cancers, and is responsible for 0.1░% of cancer deaths in men. The most common type of breast cancer seen in men is invasive ductal carcinoma, which accounts for approximately 90░% of all male breast cancers. The present study reports the case of a 97-year-old man who was diagnosed with invasive infiltrating ductal carcinoma who was treated with opioids in a palliative care unit. In this case, which is rare in the medical literature due to the type of diagnosis, sex and age of the patient, we observe that the proper use of opioids, teamwork, closeness with the family member and follow-up over time make better decisions are made about treatment, comfort and quality of life is better.
{"title":"Varón anciano con cáncer de mama tratado con opioides en unidad de cuidados paliativos de Hospital Público en El Salvador.","authors":"Hilda Aracely Magaña Guardado","doi":"10.20986/medpal.2021.1251/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1251/2021","url":null,"abstract":"Breast cancer in men is a rare disease, it represents less than 1░% of all male cancers; and almost 1░% of breast cancers, and is responsible for 0.1░% of cancer deaths in men. The most common type of breast cancer seen in men is invasive ductal carcinoma, which accounts for approximately 90░% of all male breast cancers. The present study reports the case of a 97-year-old man who was diagnosed with invasive infiltrating ductal carcinoma who was treated with opioids in a palliative care unit. In this case, which is rare in the medical literature due to the type of diagnosis, sex and age of the patient, we observe that the proper use of opioids, teamwork, closeness with the family member and follow-up over time make better decisions are made about treatment, comfort and quality of life is better.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68135242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1273/2021
Irene Martínez García, Claudio Calvo Espinós
Mesenteric panniculitis is a rare entity, and even less detected except incidentally. However, it can be associated with very prevalent symptoms in palliative care. We present a case that illustrates this problem, as a way of thinking about it.
{"title":"Paniculitis Mesentérica: ¿es algo de lo que nos tenemos que preocupar?","authors":"Irene Martínez García, Claudio Calvo Espinós","doi":"10.20986/medpal.2021.1273/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1273/2021","url":null,"abstract":"Mesenteric panniculitis is a rare entity, and even less detected except incidentally. However, it can be associated with very prevalent symptoms in palliative care. We present a case that illustrates this problem, as a way of thinking about it.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68136325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1310/2021
Miguel Angel Cuervo Pinna
{"title":"La Ley de la Eutanasia: una oportunidad para el desarrollo de los cuidados paliativos en España","authors":"Miguel Angel Cuervo Pinna","doi":"10.20986/medpal.2021.1310/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1310/2021","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68137990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/MEDPAL.2021.1155/2020
Xavier Busquet-Duran, Eva Maria Jiménez-Zafra, Magda Tura-Poma, Olga BOSC-DeLaROSA, Josep María Manresa-Domínguez, Pere Toran-Monserra
{"title":"Trayectorias de complejidad en final de vida: un estudio multicéntrico prospectivo observacional longitudinal","authors":"Xavier Busquet-Duran, Eva Maria Jiménez-Zafra, Magda Tura-Poma, Olga BOSC-DeLaROSA, Josep María Manresa-Domínguez, Pere Toran-Monserra","doi":"10.20986/MEDPAL.2021.1155/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1155/2020","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68130830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Encuesta de opinión a pacientes ingresados en un centro monográfico de cáncer sobre el modo de recibir la información. Estudio descriptivo y transversal.","authors":"Agnès Calsina-Berna, Montse Bleda Perez, Margarita Alvaro Pardo, Joaquim Juli-Torras, J. Muñoz","doi":"10.20986/MEDPAL.2021.1159/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1159/2020","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68131990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Patients with advanced cancer have a significant loss of functionality, caused by treatment and progression of pathology; in many cases aggravated by prolonged immobilization, which has a significant impact on their quality of life. Due to functional alterations and the trend in the integral treatment of the cancer patient, the role of the physiotherapist has expanded and diversified within the interdisciplinary care team. The objective of the present study is to identify the effects of physical intervention on quality of life and symptom control of cancer patients in palliative care. Material and method: A systematic review was carried out, which consulted the databases The Cochrane Central Register of Controlled Trial (CENTRAL), MEDLINE PubMed, EMBASE, PubMed, Lilacs, and PsycINFO. For prospective and ongoing trials, the WHO International Clinical Trial Registration Platform (ICTRP) search portal, the National Institute of Health clinical trials database, and the International Register of Controlled Trials were reviewed. The search was carried out between 2009 and 2019, considering four types of study design: controlled clinical trials, uncontrolled clinical trials, pre-post interventions, and cohorts. 2148 articles were founded. Results: Five articles met the inclusion criteria; men and women between 35 and 80 years of age, with advanced cancer, in palliative care treatment, intervened by physiotherapy, performed a physiotherapeutic intervention, physiotherapy intervention was compared with basic care or non-intervention, and validated scales were used for quality of life measurement and symptom control. Conclusions: Although changes in the symptomatology and quality of life of patients with advanced cancer in palliative care have been shown, it is uncertain to determine the effectiveness of Physiotherapeutic intervention in that population. Mainly because few studies were identified in the subject, finding low quality of evidence.
{"title":"Efectos de la intervención fisioterapéutica en la calidad de vida y el control de síntomas de los pacientes con cáncer avanzado en cuidados paliativos. Una revisión sistemática","authors":"Isabel Cristina Ángel Bustos, Catalina Lopera Muñetón, Silvia Patricia Betancur Bedoya, Sebastian Grajales Toro","doi":"10.20986/MEDPAL.2021.1195/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1195/2020","url":null,"abstract":"Introduction: Patients with advanced cancer have a significant loss of functionality, caused by treatment and progression of pathology; in many cases aggravated by prolonged immobilization, which has a significant impact on their quality of life. Due to functional alterations and the trend in the integral treatment of the cancer patient, the role of the physiotherapist has expanded and diversified within the interdisciplinary care team. The objective of the present study is to identify the effects of physical intervention on quality of life and symptom control of cancer patients in palliative care. Material and method: A systematic review was carried out, which consulted the databases The Cochrane Central Register of Controlled Trial (CENTRAL), MEDLINE PubMed, EMBASE, PubMed, Lilacs, and PsycINFO. For prospective and ongoing trials, the WHO International Clinical Trial Registration Platform (ICTRP) search portal, the National Institute of Health clinical trials database, and the International Register of Controlled Trials were reviewed. The search was carried out between 2009 and 2019, considering four types of study design: controlled clinical trials, uncontrolled clinical trials, pre-post interventions, and cohorts. 2148 articles were founded. Results: Five articles met the inclusion criteria; men and women between 35 and 80 years of age, with advanced cancer, in palliative care treatment, intervened by physiotherapy, performed a physiotherapeutic intervention, physiotherapy intervention was compared with basic care or non-intervention, and validated scales were used for quality of life measurement and symptom control. Conclusions: Although changes in the symptomatology and quality of life of patients with advanced cancer in palliative care have been shown, it is uncertain to determine the effectiveness of Physiotherapeutic intervention in that population. Mainly because few studies were identified in the subject, finding low quality of evidence.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68133500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/MEDPAL.2021.1227/2020
J. A. Ramos-Guerrero, L. Hernandez-Flores, Alejandro Quiroz-Hernández, Mónica Moreno-Camacho, Ramiro López-Elizalde
{"title":"Análisis Comparativo de la Necesidad de Cuidados Paliativos y la Capacidad Instalada para la Atención en el Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), México, 2019.","authors":"J. A. Ramos-Guerrero, L. Hernandez-Flores, Alejandro Quiroz-Hernández, Mónica Moreno-Camacho, Ramiro López-Elizalde","doi":"10.20986/MEDPAL.2021.1227/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1227/2020","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68134314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1256/2021
R. M. Hernández, Rafel Garay-Argandoña, Juan José Flores-Cueto
{"title":"Participación latinoamericana en la producción científica de Medicina Paliativa","authors":"R. M. Hernández, Rafel Garay-Argandoña, Juan José Flores-Cueto","doi":"10.20986/medpal.2021.1256/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1256/2021","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68135434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1265/2021
M. Cruellas, Marta Gascón Ruiz, Natalia Alonso Marin, Maitane Ocariz Diez, M. Alejandro, Rodrigo Lastra del Prado, José Ramón López Pardo, María Zapata García, María Zurera Berjaga, Alba Moratiel Pellitero, Ines Ruiz Moreno
Introduction: Infections at the end of life in cancer patients are an important cause of morbidity and mortality, and the indications for antibiotic therapy in this context are not clear. Objectives: Describe the use of antibiotics at the end of life and analyze its relationship with the characteristics of the oncological disease, functional status and probability of discharge upon admission. Methodology: Retrospective study of deceased patients in the oncology ward limited to a period of 7 months between May 1 and December 31, 2019. The number of patients included was 101. The percentage of patients who received antibiotic treatment during their admission and the time elapsed between the last dose and exitus lethalis were evaluated. Results: The mean age was 65.3 years and 54.5 % were men. 23.7 % had an ECOG<2, 63.3 %≥2. The most frequent location of the primary tumor was the lung (38.6 %). 53 % of the patients received palliative chemotherapy at the time of admission, and 66.3 % were in disease progression. In 72.3 % the probability of discharge upon admission was low. The main suspected infectious focus was the respiratory (27.7 %) followed by the abdominal (18.8 %). 58.4 % received antibiotic treatment. The most frequently used antimicrobial was amoxicillin-clavulanate (36.2 %). Regarding the search for the microorganism responsible for the patient's probable infectious condition, blood culture was obtained in 23 patients (23 %), urine culture in 12 (12 %), stool culture in 7 (7 %) and sputum culture in 10 patients (10 %). Microorganisms were isolated in 9 blood cultures, 4 urine cultures, one stool culture and 2 sputum cultures respectively. The most frequently isolated microorganisms in the positive cultures were: Escherichia coli (4), Pseudomonas aeruginosa (2) and Clostridium perfringens (2). Conclusion: The population of patients receiving antimicrobials at the end of life is quite homogeneous in terms of its clinical characteristics and presents a high incidence of infections with a high frequency of antimicrobial use. Although 58 % of the patients received antimicrobials, in only 23 % the causative agent was identified. This is a retrospective study with a small sample of patients and further prospective studies are necessary.
{"title":"Estudio retrospectivo del uso de antimicrobianos en pacientes que fallecen en un servicio de oncología","authors":"M. Cruellas, Marta Gascón Ruiz, Natalia Alonso Marin, Maitane Ocariz Diez, M. Alejandro, Rodrigo Lastra del Prado, José Ramón López Pardo, María Zapata García, María Zurera Berjaga, Alba Moratiel Pellitero, Ines Ruiz Moreno","doi":"10.20986/medpal.2021.1265/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1265/2021","url":null,"abstract":"Introduction: Infections at the end of life in cancer patients are an important cause of morbidity and mortality, and the indications for antibiotic therapy in this context are not clear. Objectives: Describe the use of antibiotics at the end of life and analyze its relationship with the characteristics of the oncological disease, functional status and probability of discharge upon admission. Methodology: Retrospective study of deceased patients in the oncology ward limited to a period of 7 months between May 1 and December 31, 2019. The number of patients included was 101. The percentage of patients who received antibiotic treatment during their admission and the time elapsed between the last dose and exitus lethalis were evaluated. Results: The mean age was 65.3 years and 54.5 % were men. 23.7 % had an ECOG<2, 63.3 %≥2. The most frequent location of the primary tumor was the lung (38.6 %). 53 % of the patients received palliative chemotherapy at the time of admission, and 66.3 % were in disease progression. In 72.3 % the probability of discharge upon admission was low. The main suspected infectious focus was the respiratory (27.7 %) followed by the abdominal (18.8 %). 58.4 % received antibiotic treatment. The most frequently used antimicrobial was amoxicillin-clavulanate (36.2 %). Regarding the search for the microorganism responsible for the patient's probable infectious condition, blood culture was obtained in 23 patients (23 %), urine culture in 12 (12 %), stool culture in 7 (7 %) and sputum culture in 10 patients (10 %). Microorganisms were isolated in 9 blood cultures, 4 urine cultures, one stool culture and 2 sputum cultures respectively. The most frequently isolated microorganisms in the positive cultures were: Escherichia coli (4), Pseudomonas aeruginosa (2) and Clostridium perfringens (2). Conclusion: The population of patients receiving antimicrobials at the end of life is quite homogeneous in terms of its clinical characteristics and presents a high incidence of infections with a high frequency of antimicrobial use. Although 58 % of the patients received antimicrobials, in only 23 % the causative agent was identified. This is a retrospective study with a small sample of patients and further prospective studies are necessary.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68136669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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