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1.
Clin Transl Oncol ; 18(11): 1088-1097, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26856600

RESUMEN

INTRODUCTION: There is no unanimous consensus on the clinical features to define breakthrough cancer pain (BTcP). The current project aimed to investigate the opinion of a panel of experts on cancer pain on how to define, diagnose, assess, treat and monitor BTcP. MATERIALS AND METHODS: A two-round Spanish multi-centre exploratory Delphi study was conducted with medical experts (n = 90) previously selected from Medical Oncology Services, Radiation Oncology, Palliative Care/Home Care Teams, and Pain Units. The study intended to seek experts' consensus and to define a set of recommendations for the management of BTcP. RESULTS: It was generally agreed that, definition of BTcP implies that baseline pain should be controlled (84 %), although not necessarily with opioids (only 30 %); there must be exacerbations (98.9 %); the duration of each episode should last <1 h (70 %); the intensity of pain ≥7 out of 10 (67.8 %); and the number of flares per day should not be less than four. All participants supported the use of the Davies algorithm for the diagnosis. The use of a 'Patient Diary' was highly recommended. The optimal treatment should have a rapid onset, a short-acting analgesic effect (1-2 h) and transmucosal nasal or oral administration. It was considered very important to develop protocols for the management of cancer pain. CONCLUSIONS: The present Delphi study identified a set of recommendations to define, assess and monitor BTcP.


Asunto(s)
Dolor Irruptivo/diagnóstico , Dolor Irruptivo/terapia , Dolor en Cáncer/diagnóstico , Dolor en Cáncer/terapia , Consenso , Técnica Delphi , Manejo del Dolor/métodos
2.
Rev. esp. patol. torac ; 32(3): 188-194, oct. 2020. tab, mapas
Artículo en Español | IBECS (España) | ID: ibc-197928

RESUMEN

OBJETIVO: analizar el patrón espacial de la mortalidad por EPOC en los municipios de la provincia de Sevilla durante el período 2013-2017. SUJETOS Y MÉTODO: los datos de mortalidad por EPOC y las poblaciones necesarias para el cálculo de los indicadores fueron facilitados por el Instituto de Estadística de Andalucía. Para analizar el patrón espacial de la mortalidad por EPOC a nivel de los municipios de Sevilla se usaron tres estimadores de riesgo: la Razón de Mortalidad Estandarizada (RME), el Riesgo Relativo Suavizado (RRs) y la Probabilidad Posteriores (PP) de que el RRs sea mayor que 1. RESULTADOS: los valores de RRs en los hombres oscilan entre 0,95 en Mairena del Alcor y 1,9 en Badolatosa y El Real de la Jara y en las mujeres los valores oscilan entre 0,78 en La Puebla de Cazalla y 3,4 en Lora del Rio. Se observan 76 municipios en los hombres y 23 en las mujeres con una PP mayor o igual a 0,80. CONCLUSIÓN: nuestros hallazgos ayudan a identificar áreas de alto riesgo para futuros estudios más completos destinados a identificar los factores de riesgo específicos asociados con las áreas críticas observadas y para guiar los esfuerzos de control de la EPOC


OBJECTIVE: to analyze the spatial pattern of COPD mortality in the municipalities of the province of Seville during the 2013-2017 period. SUBJECTS AND METHOD: the COPD mortality data and the populations needed to calculate the indicators were provided by the Andalusian Institute of Statistics. To analyze the spatial pattern of COPD mortality at the level of the municipalities of Seville, three risk estimators were used: Standardized Mortality Ratio (SMR), Relative Risk Smoothing (RRs) and Posterior Probability (PP) that the RRs is greater than 1. RESULTS: RRs values in men range between 0.95 in Mairena del Alcor and 1.9 in Badolatosa and Real de la Jara and in women the values range between 0.78 in La Puebla de Cazalla and 3.4 in Lora del Rio. There are 76 municipalities in men and 23 in women with a PP greater than or equal to 0.80. CONCLUSION: our findings help identify high-risk areas for more complete future studies to identify specific risk factors associated with the critical areas observed and to guide COPD control efforts


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Análisis Espacial , España , Factores de Riesgo , Enfermedad Pulmonar Obstructiva Crónica/prevención & control , Clasificación Internacional de Enfermedades , Indicadores de Salud
3.
Clin. transl. oncol. (Print) ; 18(11): 1088-1097, nov. 2016. tab, graf
Artículo en Inglés | IBECS (España) | ID: ibc-156874

RESUMEN

Introduction. There is no unanimous consensus on the clinical features to define breakthrough cancer pain (BTcP). The current project aimed to investigate the opinion of a panel of experts on cancer pain on how to define, diagnose, assess, treat and monitor BTcP. Materials and methods. A two-round Spanish multi-centre exploratory Delphi study was conducted with medical experts (n = 90) previously selected from Medical Oncology Services, Radiation Oncology, Palliative Care/Home Care Teams, and Pain Units. The study intended to seek experts’ consensus and to define a set of recommendations for the management of BTcP. Results. It was generally agreed that, definition of BTcP implies that baseline pain should be controlled (84 %), although not necessarily with opioids (only 30 %); there must be exacerbations (98.9 %); the duration of each episode should last < 1 h (70 %); the intensity of pain ≥7 out of 10 (67.8 %); and the number of flares per day should not be less than four. All participants supported the use of the Davies algorithm for the diagnosis. The use of a ‘Patient Diary’ was highly recommended. The optimal treatment should have a rapid onset, a short-acting analgesic effect (1-2 h) and transmucosal nasal or oral administration. It was considered very important to develop protocols for the management of cancer pain. Conclusions. The present Delphi study identified a set of recommendations to define, assess and monitor BTcP (AU)


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Asunto(s)
Humanos , Masculino , Femenino , Conferencias de Consenso como Asunto , Manejo del Dolor/instrumentación , Manejo del Dolor/métodos , Técnica Delphi , Calidad de Vida , Dimensión del Dolor , Encuestas y Cuestionarios , Análisis de Datos/métodos , Analgesia/instrumentación , Analgesia/métodos , Analgesia
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