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1.
J Clin Nurs ; 32(13-14): 3496-3503, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35799407

RESUMO

BACKGROUND: Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL). OBJECTIVES: To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features. DESIGN: Observational, cross-sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day-care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days. METHODS: Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies. RESULTS: Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0-8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%). CONCLUSIONS: Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance. PATIENT CONTRIBUTION: Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life.


Assuntos
Esclerose Múltipla , Espasticidade Muscular , Enfermeiros Especialistas , Esclerose Múltipla/complicações , Enfermeiras e Enfermeiros , Atividades Cotidianas , Qualidade de Vida , Humanos , Masculino , Feminino , Adolescente , Pessoa de Meia-Idade , Espanha , Adulto , Idoso , Estudos Transversais
5.
Anticancer Res ; 35(9): 4871-5, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26254381

RESUMO

Pulmonary blastomas are rare malignant tumors, comprising only 0.25-0.5% of all malignant lung neoplasms. The prognosis of pulmonary blastoma is very poor, with an overall five-year survival of 16%. No standard treatment has been defined for unresectable disease. We present the case of a 25-year-old woman with unresectable locally advanced classic biphasic pulmonary blastoma (CBPB) successfully treated with neodjuvant chemoradiotherapy based on two chemotherapy induction cycles of cisplatin plus etoposide, followed by concurrent weekly cisplatin to 50.4 Gy radiotherapy treatment. The patient had a significant reduction in tumor size, allowing for complete resection by pneumonectomy. Molecular study for epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK), proto-oncogene receptor tyrosine kinase (ROS1) and rearranged during transfection (RET) rearrangements, and programmed death ligand 1 (PD-L1) expression was performed in the pre-treatment tumor sample. Our patient presented a high expression (>90% of tumor cells) of PD-L1. To our knowledge, this is the first report of PD-L1 expression in CBPB. This could lead to new treatment options based on new immunotherapy agents blocking the PD-1/PD-L1 pathway for this rare disease with poor prognosis.


Assuntos
Antígeno B7-H1/metabolismo , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/terapia , Terapia Neoadjuvante , Blastoma Pulmonar/metabolismo , Blastoma Pulmonar/terapia , Adulto , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Proto-Oncogene Mas , Blastoma Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X
6.
J Laparoendosc Adv Surg Tech A ; 13(2): 121-2, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12737728

RESUMO

Video-assisted thoracoscopic surgery is a well-established method for managing persistent air leak in spontaneous pneumothorax. We describe a case of complicated spontaneous secondary pneumothorax in a patient with bullous emphysema that was treated by video-assisted manual suture of the bronchial fistula at the end of the right upper bronchus.


Assuntos
Fístula Brônquica/complicações , Fístula Brônquica/cirurgia , Enfisema/complicações , Pneumotórax/cirurgia , Cirurgia Vídeoassistida , Adulto , Enfisema/cirurgia , Humanos , Masculino , Pneumotórax/etiologia , Técnicas de Sutura
8.
Cir Esp ; 81(6): 335-8, 2007 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-17553406

RESUMO

INTRODUCTION: A short-stay thoracic surgery program was implemented and a prospective study was initiated to evaluate its results. OBJECTIVE: To analyze the results of the short-stay thoracic surgery program. PATIENTS AND METHOD: The results of 350 procedures (283 lobectomies and 67 pneumonectomies) performed between 2001 and 2005 were analyzed. The variables analyzed were: a) mean length of stay, b) mortality, c) complications, and d) readmission rate. RESULTS: The mean length of postoperative stay was 5.8 +/- 2.8 days for lobectomy and 5.36 +/- 1.8 days for pneumonectomy. Mortality was 3.5% in lobectomy and 3% in pneumonectomy. Complications occurred in 17.3% of lobectomies and 23.8% of pneumonectomies. The readmission rate was 7%. CONCLUSIONS: The results obtained show that, as expected, the short-stay thoracic surgery program reduces the mean length of hospital stay. Moreover, this program is safe, since mortality and morbidity were lower than or similar to the mean and the readmissions rate was similar to the national average. These results have encouraged us to continue the program started in 1998.


Assuntos
Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Inquéritos e Questionários , Cirurgia Torácica/estatística & dados numéricos , Humanos , Readmissão do Paciente/estatística & dados numéricos , Pneumonectomia/estatística & dados numéricos , Complicações Pós-Operatórias/mortalidade , Estudos Prospectivos , Psicocirurgia/estatística & dados numéricos
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