martes, 28 de junio de 2016

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.
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
Pacientes con cáncer, servicio de emergencias y cuidados paliativos
Cancer patients, emergencies service and provision of palliative care.
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.

Integrando el cuidado paliativo en departamentos de urgencias oncológicas. Retos y oportunidades
Integrating palliative care in oncologic emergency departments: Challenges and opportunities.
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

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
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Anestesiología y Medicina del Dolor

52 664 6848905

domingo, 26 de junio de 2016

BIBLIOTECOLOGÍA. Noticias


E-Books
NOTICIAS


CNET en Español

Apple comienza a pagar US$400 millones a compradores de 'e-books'
CNET en Español
... denunciada en 2012 conjuntamente con varias editoriales, que habrían sido encontradas culpables de forzar la subida de precio de los e-books.




Geek's Room (blog)

2016 All-Inclusive Security IT Kit: 4 eBooks gratis por tiempo limitado sobre seguridad…
Geek's Room (blog)
Este kit compuesto por 4 eBooks sobre seguridad incluye el libro “The Database Hacker's Handbook” además de otros 3 libros, que en conjunto ...



GACETA CARTAGONOVA (Comunicado de prensa)

Las Bibliotecas Municipales ofertaran 4. 682 ebooks tras la creacion de una plataforma comun con ...
GACETA CARTAGONOVA (Comunicado de prensa)
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El nuevo capítulo de las grandes librerías
New York Times en Español
Read in English. PARÍS – Gauthier Charrier, un estudiante de diseño gráfico, entró a una de las librerías más modernas de París y se preguntó: ...




RPP Noticias

Las librerías se revelan
Milenio.com
Lam Wing-kee fue detenido durante ocho meses por la policía china, acusado de distribuir “librosprohibidos” desde Hong Kong. Ahora, afirma el ...




La Opinión de Murcia

Mucho más que librerías
La Opinión de Murcia
Esta es la concepción de dos nuevas librerías abiertas recientemente, La Madriguera del Conejo Blanco y La Montaña Mágica, en Murcia y ...


Ver más resultados | Editar esta alerta
bibliotecarios
NOTICIAS


20minutos.es

Un curso de la DPH da claves a los bibliotecarios para recomendar literatura infantil y juvenil
20minutos.es
La Diputación de Huesca organiza desde los años 90 estas jornadas destinadas a bibliotecariosmunicipales, de manera que puedan ir actualizando ...



Grupo G8 concede sus títulos de servicios bibliotecarios y atención al usuario
El Faro Digital
El Centro de Formación de Grupo G8 informó ayer de la entrega a comienzos de esta semana de los diplomas a los alumnos de Prestación de ...




Hoy

CREARÁN CONSORCIO DE BIBLIOTECARIOS
Hoy
Representantes de 15 instituciones educativas de nivel superior de esta localidad van a crear un consorcio de bibliotecarios, para lo cual llevan a ...





Clarín.com

La Biblioteca Nacional relanza sus talleres gratuitos
Clarín.com
La Biblioteca Nacional anunció la convocatoria para sus talleres gratuitos y abiertos a la comunidad, a cargo de figuras del campo de la narrativa, ...




Nueva Ciudad

Vuelven los talleres gratuitos a la Biblioteca Nacional
Nueva Ciudad
Vuelven los talleres gratuitos a la Biblioteca Nacional. Gabriela Cabezón Cámara, Luis Mey, Guillermo Martínez y María Moreno son algunos de los ...




LA NACION (Argentina)

Rastros de Borges: las huellas de su biblioteca más personal
LA NACION (Argentina)
A partir del hallazgo, casi azaroso, de unos 50 libros "olvidados" por Jorge Luis Borges en el antiguo edificio de la Biblioteca Nacional de la calle ...





El Periódico

Dejen las bibliotecas abiertas en agosto
El Periódico
El artículo del señor Espinàs, 'La función social de las bibliotecas', seguro que nos ha llegado a muchos. En ellas hemos estudiado y hemos ...



El Diario Montanes

Las bibliotecas de Santander rechazan al año 10.000 libros que donan los vecinos
El Diario Montanes
El director de la Biblioteca Municipal de Santander, Pablo Susinos, muestra el tipo de colecciones que ya no cogen. / Roberto Ruiz ...




Diario Córdoba

La Red Municipal de Bibliotecas publica una recopilación de relatos de sus talleres
Diario Córdoba
La Red de Bibliotecas del Ayuntamiento de Córdoba publica bajo el título 'Fábrica de textos. Relatos breves' una recopilación de las obras ...
Publican los trabajos de los talleres de las bibliotecas - Diario Córdoba
Cobertura total de la noticia

Más sobre dolor episódico en cáncer / More on breakthrough cancer pain

Junio 26, 2016. No. 2369




Recomendaciones Canadienses para el manejo del dolor episódico por cáncer
Canadian recommendations for the management of breakthrough cancer pain.
Curr Oncol. 2016 Apr;23(2):96-108. doi: 10.3747/co.23.2865. Epub 2016 Apr 13.
Abstract
Breakthrough cancer pain (btcp) represents an important element in the spectrum of cancer pain management. Because most btcp episodes peak in intensity within a few minutes, speed of medication onset is crucial for proper control. In Canada, several current provincial guidelines for the management of cancer pain include a brief discussion about the treatment of btcp; however, there are no uniform national recommendations for the management of btcp. That lack, accompanied by unequal access to pain medication across the country, contributes to both regional and provincial variability in the management of btcp. Currently, immediate-release oral opioids are the treatment of choice for btcp. This approach might not always offer optimal speed for onset of action and duration to match the rapid nature of an episode of btcp. Novel transmucosal fentanyl formulations might be more appropriate for some types of btcp, but limited access to such drugs hinders their use. In addition, the recognition of btcp and its proper assessment, which are crucial steps toward appropriate treatment selection, remain challenging for many health care professionals. To facilitate appropriate management of btcp, a group of prominent Canadian specialists in palliative care, oncology, and anesthesiology convened to develop a set of recommendations and suggestions to assist Canadian health care providers in the treatment of btcp and the alleviation of the suffering and discomfort experienced by adult cancer patients.
KEYWORDS: Breakthrough cancer pain
Dolor episódico: definición, etiología y epidemiología
M. Nabal y F. Madrid
R e v. Soc. Esp. Dolor 9: 88-93, 200
R E S U M E N
El dolor episódico (D.E.) se define como la pres e n t a c i ó n de un dolor agudo transitorio en un paciente (con cáncer)cuyo dolor basal está controlado. Bajo este apelativo se incluyen el dolor incidental, el dolor de final de dosis y el dolor irruptivo. Las características epidemiológicas de este tipo de dolor son difíciles de precisar ya que no existe un consenso en la nomenclatura anglosajona sobre el tema, pe r o su prevalencia oscila entre el 19 y el 93% según las distintas series. El número medio de episodios descrito es de 4 (1-3600). La mitad de los dolores episódicos tienen un inicio brusco y una duración media inferior a 30 minutos. En todos los casos se describe la intensidad de los episodios de dolor como severa o muy severa. Los  mecanismos implicados en la aparición de este tipo de dolor son en propo r ciones similares: viscerales, somáticos, neuropáticos o mixtos. Hasta la fecha no disponemos de sistemas específicos para evaluar este tipo de dolor; y contamos con escasas herramientas terapéuticas específicas lo cual puede contribuir al desconocimiento sobre el tema. El presente trabajo pr etende profundizar en este tipo de dolor a partir de una revisión de la bibliografía disponible. © 2002 Sociedad Española del Dolor. Publicado por Arán Ediciones, S.L.
Palabras clave: Dolor episódico. Dolor incidental. Dolor irruptivo. Cuidados paliativos.
Que hacer y que no hacer cuando se diagnostica y trata en dolor episódico por cáncer. Opiniones de expertos
What to Do, and What Not to Do, When Diagnosing and Treating Breakthrough Cancer Pain (BTcP): Expert Opinion.
Drugs. 2016 Mar;76(3):315-30. doi: 10.1007/s40265-015-0519-2.
Abstract
Clinical management of breakthrough cancer pain (BTcP) is still not satisfactory despite the availability of effective pharmacological agents. This is in part linked to the lack of clarity regarding certain essential aspects of BTcP, including terminology, definition, epidemiology and assessment. Other barriers to effective management include a widespread prejudice among doctors and patients concerning the use of opioids, and inadequate assessment of pain severity, resulting in the prescription of ineffective drugs or doses. This review presents an overview of the appropriate and inappropriate actions to take in the diagnosis and treatment of BTcP, as determined by a panel of experts in the field. The ultimate aim is to provide a practical contribution to the unresolved issues in the management of BTcP. Five 'things to do' and five 'things not to do' in the diagnosis and treatment of BTcP are proposed, and evidence supporting said recommendations are described. It is the duty of all healthcare workers involved in managing cancer patients to be mindful of the possibility of BTcP occurrence and not to underestimate its severity. It is vital that all the necessary steps are carried out to establish an accurate and timely diagnosis, principally by establishing effective communication with the patient, the main information source. It is crucial that BTcP is treated with an effective pharmacological regimen and drug(s), dose and administration route prescribed are designed to suit the particular type of pain and importantly the individual needs of the patient.

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
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

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