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2.
Rev Lat Am Enfermagem ; 28: e3377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027406

RESUMO

OBJECTIVE: to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care. METHOD: a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers. RESULTS: eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%). CONCLUSION: while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.


Assuntos
Terapia por Acupuntura , Dor do Câncer , Terapias Complementares , Neoplasias , Adulto , Dor do Câncer/terapia , Humanos , Massagem , Neoplasias/complicações , Neoplasias/terapia , Cuidados Paliativos
6.
Washington, D.C.; OPS; 2020-10-01.
em Espanhol | PAHO-IRIS | ID: phr-52784

RESUMO

[Resumen]. En este manual práctico sobre se aborda la planificación e implantación de servicios de cuidados paliativos, integrados en los servicios de atención de salud existentes, a nivel nacional o subnacional. Está dirigido principalmente a los directores de programa de salud de los niveles nacional, provincial o distrital, responsables de programas relacionados con enfermedades no transmisibles, enfermedades infecciosas, servicios de salud u otras áreas técnicas en las que los cuidados paliativos son importantes. En él se procura describir una gama de opciones y puntos de partida para establecer y fortalecer servicios de cuidados paliativos. En cada apartado, y en la medida de lo posible, se esboza un enfoque progresivo, con énfasis en abordajes factibles para entornos de ingresos bajos y medianos. Este documento debe contribuir al acceso equitativo a buenos cuidados paliativos en el contexto de la cobertura universal de salud y debe ayudar a los países a fortalecer los programas de cuidados paliativos, especialmente en el nivel de la atención primaria de salud y para todos los grupos de enfermedades. El enfoque se basa en estrategias centradas en la persona y busca abordar las necesidades y expectativas de los pacientes.


Assuntos
Doenças não Transmissíveis , Neoplasias , Serviços de Saúde , Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos , Sistemas de Saúde
7.
Praxis (Bern 1994) ; 109(13): 1070-1073, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33050809

RESUMO

Unusual Cause of Acute Kidney Failure in a Patient with Metastatic Bladder Carcinoma Undergoing Palliative Chemotherapy Abstract. Tumour lysis syndrome is a potentially life-threatening complication of cancer and its treatment. It mostly occurs in highly proliferative haematological neoplasms under cytotoxic therapy but can also be seen spontaneously and in solid neoplasms, particularly with high tumour burden and/or high chemosensitivity. The present case report describes a tumour lysis syndrome in a patient with metastatic bladder cancer with an elevated lactate dehydrogenase as only potential correlate of a high tumour burden.


Assuntos
Lesão Renal Aguda , Síndrome de Lise Tumoral , Neoplasias da Bexiga Urinária , Lesão Renal Aguda/etnologia , Antineoplásicos/uso terapêutico , Humanos , Cuidados Paliativos , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/tratamento farmacológico
8.
Einstein (Sao Paulo) ; 18: eAO5539, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053019

RESUMO

OBJECTIVE: To translate and make cross-cultural adaptation of NECPAL CCOMS-ICO© tool to Portuguese, and to analyze its semantic validity. METHODS: A methodological research about NECPAL CCOMS-ICO© tool cross-cultural adaptation, translated from Spanish into Portuguese and measurement of semantic validity. The cross-cultural adaptation process was conducted according to Beaton recommendations, including translation, translation synthesis, back-translation, and analysis of semantic, idiomatic, conceptual, and cultural equivalence of translated and back-translated tool versions, resulting in a pre-final version, which was submitted to a pre-test (n=35). Contend Validity Index was calculated to analyze semantic validity. RESULTS: Cross-cultural adaptation process allowed us to prepare the final version of this tool, which was named NECPAL-BR. Collected data from pre-testing step enabled the analysis of semantic validity. The Content Validity Index observed at this step was 0.94. CONCLUSION: The semantic validity of the tool in its Portuguese version was confirmed; therefore, it may assist in screening chronic progressive disease patients, aiming to provide early palliative care. It may also be used to develop clinical and team performance indicators, and be employed as a care management tool designed to optimize resources.


Assuntos
Comparação Transcultural , Cuidados Paliativos/normas , Semântica , Inquéritos e Questionários/normas , Humanos , Portugal , Reprodutibilidade dos Testes , Traduções
9.
Wiad Lek ; 73(8): 1681-1689, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055334

RESUMO

OBJECTIVE: The aim: To evaluate the quality of life (QoL) of palliative patients receiving general palliative care and the impact of palliative care provided by mobile palliative care team (MPCT) on their QoL. PATIENTS AND METHODS: Materials and methods: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (QLQ-C30) was used to evaluate QoL of 219 palliative patients receiving general palliative care from family physicians in the Center for primary health care of Uzhhorod city, Ukraine. In the second part of the study, the subgroup of 25 patients who had at least one of fifteen QLQ-C30 scales evaluated lower than 50 points were selected. They were provided with PC from the MPCT for 2 weeks and their QoL was measured again. RESULTS: Results: For the patients who received general palliative care from a family physicians mean m (SD) QoL value was 38.63 (16.9), and the main symptoms that affected QoL were fatigue 48.60 (23.30) and pain 46.11 (20.97). The most impact on QoL scores had role (rs=0,430;), emotional (0.321) and physical (0.301) functioning and such symptoms as pain (-0.392), insomnia (-0.311), dyspnoea (-0.294), financial difficulties (-0.255). For the patients who received palliative care from MPCT mean the mean QoL score increased by 30.0 points, mean pain score decreased by 42.22 points, fatigue score decreased by 38.0 points and level of financial difficulties also decreased by 76.0 points. CONCLUSION: Conclusions: The involvement of the MPCT could have a significant positive impact on the QoL of palliative patients.


Assuntos
Cuidados Paliativos , Qualidade de Vida , Fadiga , Humanos , Médicos de Família , Ucrânia
15.
Medwave ; 20(8): e8012, 2020 Sep 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32956343

RESUMO

Objective: To generate recommendations on the management of radiotherapeutic treatments during the pandemic, adapted to a country with limited health resources. Methods: We did a rapid review of the literature, searching for papers that describe any measures to reduce the risk of COVID-19 infection, as well as management guidelines to reduce the workload, in radiotherapy units. The following conditions were included in the scope of this review: gynecological tumors, breast cancer, gastrointestinal tumors, genitourinary tumors, head and neck tumors, skin cancer, tumors of the central nervous system, and lymphomas. An expert group discussed online the extracted data and drafted the recommendations. Using a modified Delphi method, the consensus was reached among 14 certificated radio-oncologists. The quality of the evidence that supported the recommendations on treatment schedules was assessed. Results: A total of 57 documents were included. Of these, 25 provided strategies to reduce the risk of infection. Recommendations for each condiction were extracted from the remaining documents. The recommendations aim to establish specific parameters where treatments can be omitted, deferred, prioritized, and shortened. Treatment schemes are recommended for each condition, prioritizing hypo-fractionated schemes whenever possible. Conclusions: We propose strategies for the management of radiotherapy services to guarantee the continuity of high-quality treatments despite the health crisis caused by COVID-19.


Assuntos
Betacoronavirus , Consenso , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/estatística & dados numéricos , Carga de Trabalho , Infecções por Coronavirus/prevenção & controle , Técnica Delfos , Desinfecção/métodos , Física Sanitária , Humanos , Higiene/normas , Neoplasias/radioterapia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/veterinária , Cuidados Paliativos/organização & administração , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade)/organização & administração , Distância Social , Triagem/organização & administração
16.
Medicine (Baltimore) ; 99(33): e21621, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32872019

RESUMO

Upper gastrointestinal stenting is a palliative treatment for relieving symptoms such as nausea, vomiting, and dietary intake in patients with obstruction due to inoperable advanced stomach cancer. Self-expandable metal stent (SEMS) implantation for malignant obstruction has recently become more effective, safer, and less expensive than operative modality. It also has better short-term outcomes, particularly a shorter hospital stay and a more rapid return to oral intake, than surgical treatment. However, there is no comparative analysis regarding the efficacy, side effects, and survival rate of stenting between the esophagogastric junction (EGJ) and pyloric obstructions.To compare the prognoses and complications after SEMS implantation between EGJ and pyloric obstructions in advanced gastric cancer.Among advanced gastric cancer patients with gastrointestinal obstruction diagnosed from January 2008 to December 2017 at the Gastroenterology Department of Chungnam National University Hospital, 42 and 76 patients presented with EGJ (EGJ obstruction group) and gastric pyloric obstructions (pyloric obstruction group), respectively. We retrospectively reviewed the survival period, changes in food intake, and complications of these patients before and after SEMS placement.The prevalences of aspiration pneumonia were 11.9% (5/42) and 2.6% (2/76) in the EGJ and pyloric obstruction groups, respectively, before SEMS placement (P value: .041). Other symptoms associated with gastric malignant obstruction were not statistically different between the groups. Success rate and adverse events did not significantly differ between the EGJ and pyloric obstruction groups. There was no difference in frequency of stent reinsertion procedures performed owing to reobstruction, but the reprocedure average period was statistically significantly longer in the EGJ obstruction group [EGJ obstruction: 158.3 days (±42.4); pyloric obstruction: 86.0 days (±29.1)] (P value: .022). As an index of improved dietary status, the Gastric Outlet Obstruction Scoring System score was not significantly different between the groups before and after SEMS placement.The EGJ and pyloric obstruction groups did not significantly differ in prognosis or complication rates. However, EGJ stent was more stable than pyloric stent when reobstruction was considered.


Assuntos
Junção Esofagogástrica/patologia , Piloro/patologia , Stents Metálicos Autoexpansíveis/efeitos adversos , Neoplasias Gástricas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Dieta , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Paliativos , Pneumonia Aspirativa/etiologia , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia
17.
J Bras Nefrol ; 42(2 suppl 1): 44-46, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877499

RESUMO

INTRODUCTION: Palliative care is an approach aimed at relieving suffering, controlling symptoms and seeking to improve quality of life. It must be offered in conjunction with standard treatment for any disease that threatens the continuation of life, such as a Covid-19 infection. DISCUSSION: The bioethical principles and strategies used by palliative medicine can assist nephrologists in the care of patients with renal dysfunction, who face the difficulties of isolation at the beginning and follow-up of dialysis in outpatient treatment, and those who are at risk for a more serious disease progress. Some of them: - a Shared decision making, which enables the patient and family to participate as facilitators in the systematization of the team's reasoning, in addition to respecting the principle of autonomy; - Symptom Management: which should be a priority to ensure relief of suffering even in times of social isolation; - Communication skills: making it possible to alleviate suffering in announcing bad news or complex decisions through communication techniques;; - Bereavement assistance: which in acute situations such as the pandemic, causing unexpected losses, the importance of sympathy from healthcare professionals becomes even greater. CONCLUSION: The principles of palliative care are essential to face the challenges of a planet-wide crisis, which raises human suffering in all dimensions, and which requires the construction of strategies that can keep patients assisted, comfortable and with measures proportional to their clinical condition and preferences.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cuidados Paliativos/métodos , Pneumonia Viral/epidemiologia , Terapia de Substituição Renal/normas , Luto , Comunicação , Tomada de Decisão Compartilhada , Humanos , Nefrologia/normas , Pandemias , Terapia de Substituição Renal/métodos , Avaliação de Sintomas/métodos
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