Cuidados paliativos / Paliative care

Junio 29, 2016. No. 2372

Tendencias de sedación continua hasta la muerte entre 2007 y 2013. Trends in Continuous Deep Sedation until Death between 2007 and 2013: A Repeated Nationwide Survey. Robijn L1,2, Cohen J1, Rietjens J1, Deliens L1,2, Chambaere K1,2. PLoS One. 2016 Jun 23;11(6):e0158188. doi: 10.1371/journal.pone.0158188. eCollection 2016. Abstract BACKGROUND: Continuous deep sedation until death is a highly debated medical practice, particularly regarding its potential to hasten death and its proper use in end-of-life care. A thorough analysis of important trends in this practice is needed to identify potentially problematic developments. This study aims to examine trends in the prevalence and practice characteristics of continuous deep sedation until death in Flanders, Belgium between 2007 and 2013, and to study variation on physicians' degree of palliative training. METHODS: Population-based death certificate study in 2007 and 2013 in Flanders, Belgium. Reporting physicians received questionnaires about medical practices preceding the patient's death. Patient characteristics, clinical characteristics (drugs used, duration, artificial nutrition/hydration, intention and consent), and palliative care training of attending physician were recorded. We posed the following question regarding continuous deep sedation: 'Was the patient continuously and deeply sedated or kept in a coma until death by the use of one or more drugs'. RESULTS: After the initial rise of continuous deep sedation to 14.5% in 2007 (95%CI 13.1%-15.9%), its use decreased to 12.0% in 2013 (95%CI 10.9%-13.2%). Compared with 2007, in 2013 opioids were less often used as sole drug and the decision to use continuous deep sedation was more often preceded by patient request. Compared to non-experts, palliative care experts more often used benzodiazepines and less often opioids, withheld artificial nutrition/hydration more often and performed sedation more often after a request from or with the consent of the patient or family. CONCLUSION: Worldwide, this study is the first to show a decrease in the prevalence of continuous deep sedation. Despite positive changes in performance and decision-making towards more compliance with due care requirements, there is still room for improvement in the use of recommended drugs and in the involvement of patients and relatives in the decision-making process. PDF Dolor y medicina paliativa Integrated pain and palliative medicine model. Bhatnagar S1, Gupta M2. Ann Palliat Med. 2016 May 24. pii: apm.2016.05.02. doi: 10.21037/apm.2016.05.02. [Epub ahead of print] Abstract Pain is one of the most common, distressing and feared symptom among cancer and other patients in need of palliative care. An estimated 25% of cancer patients and 25 million people die in pain each year. Effective pain and symptom management are the core elements of palliative carewhich aims at reducing suffering and improving quality of life (QOL) throughout the course of illness starting from diagnosis, in sync with curative treatments and at end of life. There is a prevailing shortage of manpower apt to deal with pain and providing cost-effective palliative care and with the rise of cancer, other chronic diseases and explosion of new life-prolonging therapeutic modalities, this 'Patient-pain and palliative physician' discrepancy is only going to increase, more so in developing countries. The need of the hour is to train all healthcare physicians and nurses especially those working in the field of chronic pain in principles of effective pain and symptom palliation, to integrate cancer pain and symptom management into existing pain management fellowships and to introduce a holistic pain and palliative care model at all levels of healthcare system. Simultaneously, of equal importance is to conduct research, evidence building and formulate policies and guidelines for meticulous symptom management among the diverse category of patients and diseases so as to have a personalized and individualistic approach to patient management. In this comprehensive review, we have pondered upon the need, advantages, barriers and recommendations to achieve ideal 'Integrated pain and palliative medicine' services, their equitable implementation and delivery to 'whomsoever in need of them'. PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 26 de junio de 2016
NOTICIAS


Milenio.com
Presentando FOLIO - Una nueva colaboración que reúne a bibliotecas, proveedores de servicios y ...
PR Newswire (Comunicado de prensa)
BOSTON, 25 de junio de 2016 /PRNewswire/ -- Las bibliotecas y los proveedores de servicios se han unido para transformar el futuro de las ...
Shirley Zuluaga, nueva directora de la Biblioteca Pública Piloto - El Colombiano
Cobertura total de la noticia




Critica
Organiza el IMCA programa “Mis vacaciones en la biblioteca”
Critica
Hermosillo, Sonora; Junio 25 de 2016.- Las Bibliotecas Públicas Municipales abrirán sus puertas este verano para ofrecer talleres y círculos de ...




Europa Press
Santander.- Aprobado el expediente para contratar el nuevo programa de animación a la lectura ...
Europa Press
Su objetivo es desarrollar algunas de las líneas estratégicas del Plan de Dinamización de lasBibliotecas Municipales aprobado en 2015, ...



EntornoInteligente
Ana Gonzalo Morales // BNP planteará la creación del Instituto Tecnológico para bibliotecarios
EntornoInteligente
Tweet Enviar La Ley del Sistema Nacional de Bibliotecas faculta a la Biblioteca Nacional para crear y fundar un Instituto Superior Tecnológico Público ...




TiempoSur Diario Digital
Por noveno año consecutivo el “Desafío Leer” recorre las escuelas de Río Gallegos
TiempoSur Diario Digital
Elaborado por Fundación Leer y con el apoyo de Supermercados La Anónima el “Desafío Leer” busca fortalecer el vínculo entre las bibliotecas y su ...




Diario de Los Andes
Biblioteca de Autores Tachirenses conmemorarán natalicio de Ramón J. Velásquez
Diario de Los Andes
La conferencia se realizará a las 8 am del 7 de julio en la Biblioteca “Luis Beltrán Pietro Figueroa”, de la ULA; durante la actividad también se ...




La Prensa (Nicaragua)
Las 10 curiosidades de los libros
La Prensa (Nicaragua)
Biblioteca. La biblioteca más grande del mundo es la del Congreso de Estados Unidos, fundada en 1800 en Washington; tiene 138 millones de ...




Diario de Cádiz
Libros que curan
Diario de Cádiz
Debido al importante y numeroso fondo bibliográfico del instituto, y a la puesta en marcha previa de una biblioteca libre en la cafetería, pensó que ...


Concluyen 90 alumnos talleres de Japonés y Exprés Arte –Cómics
e-consulta Veracruz
Raúl Domínguez Martínez, coordinador de Bibliotecas Municipales, indicó que la ciudadanía respondió favorablemente a la invitación por parte del ...

Paliativos y urgencias / Paliative care in emergency department

Junio 28, 2016. No. 2371

La integración de cuidados paliativos en urgencias The Integration of Palliative Care into the Emergency Department. Basol N1. Turk J Emerg Med. 2016 Mar 2;15(2):100-7. doi: 10.5505/1304.7361.2015.65983. eCollection 2015. Abstract Palliative care (PC) is a new and developing area. It aims to provide the best possible quality of life for patients with life-limiting diseases. It does not primarily include life-extending therapies, but rather tries to help patients spend the rest of their lives in the best way. PC patients often are admitted to emergency departments during the course of a disease. The approach and management of PC include differences with emergency medicine. Thus, there are some problems while providing PC in the ED. With this article, the definition, main features, benefits, and problems of providing PC are presented, with the primary aim of emphasizing the importance of PC integration into the ED. KEYWORDS: Emergency department; integration; palliative care; training PDF Pacientes con cáncer, servicio de emergencias y cuidados paliativos Cancer patients, emergencies service and provision of palliative care. Miranda B1, Vidal SA2, Mello MJ3, Lima JT4, Rêgo JC5, Pantaleão MC5, Leão VG5, Gusmão FA Filho6, Costa JI Júnior7. Rev Assoc Med Bras. 2016 May-Jun;62(3):207-211. doi: 10.1590/1806-9282.62.03.207. Abstract OBJECTIVE: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. METHOD: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011) with a minimum length of hospital stay of two hours. Student's t-test and Pearson chi-square test were used to compare the means. RESULTS:191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%). 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%), breast (13.6%) and prostate (10.5%); 70.7% were in advanced stages (IV, 47.1%); 39.4% without any cancer therapy. CONCLUSION: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals. PDF Integrando el cuidado paliativo en departamentos de urgencias oncológicas. Retos y oportunidades Integrating palliative care in oncologic emergency departments: Challenges and opportunities. Elsayem AF1, Elzubeir HE1, Brock PA1, Todd KH1. World J Clin Oncol. 2016 Apr 10;7(2):227-33. doi: 10.5306/wjco.v7.i2.227. Abstract Although visiting the emergency departments (EDs) is considered poor quality of cancer care, there are indications these visits are increasing. Similarly, there is growing interest in providing palliative care (PC) to cancer patients in EDs. However, this integration is not without major challenges. In this article, we review the literature on why cancer patients visit EDs, the rates of hospitalization and mortality for these patients, and the models for integrating PC in EDs. We discuss opportunities such integration will bring to the quality of cancer care, and resource utilization of resources. We also discuss barriers faced by this integration. We found that the most common reasons for ED visits by cancer patients are pain, fever, shortness of breath, and gastrointestinal symptoms. The majority of the patients are admitted to hospitals, about 13% of the admitted patients die during hospitalization, and some patients die in ED. Patients who receive PC at an ED have shorter hospitalization and lower resource utilization. Models based solely on increasing PC provision in EDs by PC specialists have had modest success, while very limited ED-based PC provision has had slightly higher impact. However, details of these programs are lacking, and coordination between ED based PC and hospital-wide PC is not clear. In some studies, the objectives were to improve care in the communities and reduce ED visits and hospitalizations. We conclude that as more patients receive cancer therapy late in their disease trajectory, more cancer patients will visit EDs. Integration of PC with emergency medicine will require active participation of ED physicians in providing PC to cancer patients. PC specialist should play an active role in educating ED physicians about PC, and provide timely consultations. The impact of integrating PC in EDs on quality and cost of cancer care should be studied. KEYWORDS: Cancer; Cost; Emergency department; Integration; Palliative care; Quality PDF Comité Europeo de Enseñanza en Anestesiología Curso de Actualización en Anestesiología Anestesia por Especialidades y Simposio Anestesia y Cirugía Plástica Seguras Agosto 5-7, 2016. Tijuana BC, México Información Dr. Sergio Granados Tinajero granadosts@gmail.com  16th World Congress of Anaesthesiologists 28 August - 2 September 2016  Hong Kong Convention and Exhibition Centre World Federation of Societies of Anaesthesiologists http://wca2016.com/

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org